Back to campus! Today I begin my 17th year of university teaching.
I’ve taught biology majors and non-majors, and I begin every first day of every semester the same way:
What is science?
We talk about what science is and is not. We talk about peer review. We talk about experimental design.
In the past, my examples were generic. Now, not so much.
The past two years of Covidness revealed a gaping hole in science education. At first, I was surprised, and then disappointed, and now, I’m worried.
Much of the angst and misinformation surrounding All Things Covid finds its root in a misunderstanding of how science works.
I especially love teaching non-science majors. While non-majors are unlikely to be our research scientists, they will be our teachers, politicians, policy makers, pastors, school board members, and voters.
It causes incessant itching, and sufferers often scratch their skin with a stick or rock until they bleed.
Fast-flowing rivers and streams, often sources of fresh water for remote villages, provide the perfect breeding ground for black flies. The bite of a black fly transmits a larval worm. As the worms multiply, they burrow under the skin.
As miserable as it is, it is not the itching that gives this horrid disease its name.
The worms eventually migrate to the eyes, causing infection and inflammation of the corneas and destroying vision.
River blindness debilitates, but it doesn’t kill. River blindness spreads its misery in tropical countries, primarily in Africa. More than 99% of river blindness cases are in Africa.
In the early 1980s, researchers discovered a powerful anti-parasitic compound in a dirt sample dug up near a golf course in Tokyo. The compound proved to be a powerful treatment for parasites in livestock, and a version was developed to combat the misery of parasitic infections in humans, including river blindness.
In 2015, Satoshi Omura and William Campbell shared the Nobel Prize in Medicine for discovery of this drug, capable of preventing so much human misery.
The drug? Ivermectin.
Somewhere amid all the noise of our almost two-year pandemic, Ivermectin found its moment of fame as one of a few “preventatives” and/or “treatments” for COVID-19 that the medical establishment “doesn’t want us to know about.”
“What are they trying to hide?” they say. “It’s a Nobel Prize-winning drug,” they argue.
But instead of doctor-prescribed human-sized doses, Ivermectin paste, intended for livestock, is flying off the shelves of feed stores and farm suppliers. Poison control centers and emergency rooms are inundated: nausea, vomiting, hallucinations, blurred vision, low blood pressure, seizures, coma, death.
And even in human-sized dosages, Ivermectin treats parasitic worms and arthropods, not viruses.
Despite these facts, Ivermectin is touted as both a preventative and a cure by political pundits and politicians, on YouTube channels, and by the “Front Line COVID-19 Critical Care Alliance”, a small group of doctors who disagree with the wider medical community.
So why the hype?
Early in the pandemic, a study found that Ivermectin inhibited the growth of SARS-CoV-2 in cell cultures (in Petri dishes, in a lab).
Not so fast.
In order to achieve the dosage of Ivermectin used in the Petri dish experiment in actual humans, the concentration would have to be a dose 100 times higher than is approved for use in humans – a toxic level.
Multiple studies followed: is Ivermectin effective as a preventative? Does it reduce COVID-19 symptoms? Does it reduce death or severe disease? Does it prevent hospitalization?
To date, 16 randomized-controlled trials found NO evidence that Ivermectin is effective in any way against COVID-19. None.
You know what does prevent severe disease? Vaccination.
Epidemiologist Katelyn Jetelina said it best:
Misinformation and anti-science rhetoric is killing Americans.
Henning Jacobson is the pastor of a small church in Cambridge, Massachusetts. Cambridge has been particularly hard-hit by the virus, so local officials closed libraries, schools, and churches and enacted other temporary ordinances intended to curb infections.
Pastor Jacobson, however, refused to comply with any ordinance that required him, personally, to take measures intended to stop the spread of infection. Before long, Pastor Jacobson found himself before a judge for his failure to comply.
Jacobson and a group of six other individuals argued that the local regulations were “invasions of personal liberty” and would only lead to increasing government control over individual behaviors.
Jacobson’s lawyers made a familiar argument: there goes the state again, trying to be paternalistic and violating individual rights with no reasonable grounds.
The year, however, was 1902, and the pandemic was smallpox. The ordinance to which Jacobson objected required the vaccination of all adults or pay a fine of $5.00.
A state court ruled against Jacobson, but he appealed to the Supreme Court of the United States.
In 1905, the Court ruled that a community has the right to invoke ordinances intended to protect the health and safety of the public. Justice John Marshall Harlan made the point: just as governments can curtail freedoms during a wartime invasion, governments can likewise curtail freedoms during the “invasion” of a disease.
Things haven’t changed much in a century.
The CDC and local health departments are not only battling vaccine hesitancy, but also compliance with mask-wearing, distancing, and occupancy limits during the vaccine rollout.
There is good news, however.
Sixty-nine percent of Americans now say they have been vaccinated or will likely be vaccinated – a relieving jump from the all-time low of fifty-one percent who said so last fall at the height of the presidential election.
Unfortunately, it’s not all good news. A deeper dive into the “sixty-nine percent” reveals a disturbing breakdown, specifically in religious demographic groups.
Among Americans, the group least likely to get a Covid-19 vaccine are white evangelicals. Forty-five percent of white evangelicals say they definitely will not/probably will not get the vaccine. Other evangelical and protestant groups and Catholics are much more likely to get the vaccine.
Ninety percent of atheists plan to “definitely” take the vaccine.
But there’s more.
And it makes me really sad.
White evangelicals are the LEAST likely to consider the health of their community when making a decision about the vaccine. Only 48% said they would consider the health of their community “a lot” when making a decision. The percentages are much higher (almost 70%) in other protestant groups, Catholics, and non-religious Americans.
It is no surprise that resistance to mask-wearing tracks with vaccine refusal. Anti-mask and anti-vaccine are two sides of the same coin. As advocates for “health freedom”, both groups find reasons to mistrust both science and scientists.
Like Pastor Jacobson, many people see masks as an assault on their personal freedom. How many times have you heard a variation on this theme? “Wear a mask if YOU want to, just don’t force me to wear one.”
The primary purpose of a mask is not to protect the mask-wearer. Wearing a mask primarily protects others.
This is established science.
Although less than seven percent of the population was vaccinated, the governor of Texas recently lifted the state mask mandate, setting off a firestorm of opposing positions. While some Texans hurled their masks into literal fires in a celebration of freedom, others warned of the continuing dangers of community spread with vaccination rates still in single digits.
And then there are those pesky variants.
A virus can only mutate within a host. The more hosts (people) spreading a virus in a community, the higher the chance for a variant to arise.
Herd immunity for a more transmissible virus requires a higher percentage of immunized people. Continued mask-wearing protects a community until an effective percentage of the population is vaccinated.
Sometimes loving your neighbor means forgoing a freedom.
During the Cold War, the greatest fear in America was the bomb.
In a close second place was polio.
Everyone was at risk, children especially, but also teenagers and adults. Polio returned every year, usually during the summer. There was no prevention and no cure.
People got sick, some got very sick. Many lost the use of their legs, their arms, or both. Many lost the ability to breathe, and some lost their lives.
Americans were terrified.
But on an unremarkable Tuesday in April 1955, everything changed.
Church bells rang and factory whistles blew. Across America, people ran into the streets weeping.
In all caps, newspaper headlines shouted: “THE VACCINE WORKS.”
After two years of trials, it was certain: Jonas Salk’s polio vaccine worked.
In the next few days and weeks, store front windows were shoe-polished with “Thank you, Dr. Salk.” Local parades featured floats celebrating the defeat of polio. President Eisenhour choked up when he met Dr. Salk at the White House.
For decades, Americans saw polio as a shared tragedy. In the wake of the Depression when philanthropist money dried up, ordinary people mailed in dimes to fight polio. Literally tons of dimes.
It was the March of Dimes that funded Salk’s research.
Volunteers organized an unprecedented two million American children in the largest vaccine trial ever completed. Smiling kids posed for photos wearing “Polio Pioneer” buttons.
No wonder Americans were proud.
They saw themselves as part of a group. Americans cared not only for their own children, but for America’s children. They were a public that cared about public health.
Americans have Covid fatigue. We are tired, just tired of it. We are appalled by the record deaths and the packed ICUs and the exhausted medical staffs and the damaged economy and the never-ending social distancing.
But then, hope.
It began with front-line medical staff smiling through their masks, giving weary thumbs-up in vaccine selfies on social media. Then more medical staff. More selfies.
And we loved it. We cheered and hit “like” and a lot of us teared up with every posting.
March 2020 seems like a million years ago. We now have two vaccines that are 95% effective, and we can’t get them into arms fast enough.
I received my first dose of the Moderna vaccine at a mega drive through at Texas Motor Speedway. Drones and helicopters flew overhead, and the media was about with mics and cameras.
Volunteers and paramedics and medical staff were there by the hundreds, waving and smiling and chatting, and all the while maintaining efficiency like you just can’t believe.
People were rolling down their windows and waving and thanking the staff and the volunteers.
I witnessed the same scene at a mega center in Dallas where my 82-year-old mother-in-law received her first jab. Big smiles everywhere. Organization, volunteers, hopefulness, thankfulness, celebration.
As more and more of us are called in for our jabs, social media selfies have not abated. It’s our twenty-first century version of church bells ringing and factory whistles blowing.
Vaccine rollout has not been problem-free, nor was the celebrated polio vaccine rollout. Some vaccination sites run with the efficiency of a Chick-fil-A drive-through, while other sites struggle.
But we are hopeful. And our civic pride is showing.
We cheer, we take selfies, we heart the photos. We delight in the stories: the medical team, stalled on a highway in a blizzard with a soon to expire supply of vaccine, going car to car, vaccinating every willing arm; the hospital in California rushing against time to vaccinate their community after a freezer failure; the health care workers made honorary Super Bowl captains.
I am vaccinated for myself, sure, but it is so much more:
I am vaccinated because I want to protect my neighbors living in crowded conditions, my neighbors for whom “working from home” is not an option, my newborn neighbors, my immunocompromised neighbors, my elderly neighbors, and my teacher neighbors.
I am vaccinated because I want to be a responsible member of the herd. It’s how I love my neighbor as myself.
Let the church bells ring.
It’s not a Polio Pioneer button, but I love my pin!
Late on a Monday morning in early January, senior staff at a hospital in Mendocino County, California were gathered for the first executive meeting of 2021, when in burst the hospital pharmacist.
Ten hours earlier, the compressor on the hospital’s freezer failed.
In a perfect storm of coincidences, the alarm meant to sound in such a failure also failed.
And in a trifecta of disasters, the freezer held 830 doses of the Moderna Covid-19 vaccine.
Two hours was all that was left in the shelf life of 830 doses of a groundbreaking, life-saving, but temperature-finicky RNA vaccine.
Phone call number one was to Moderna, but there was no time to waste waiting on a callback.
Fifteen minutes off the clock.
The hospital shifted into local emergency mode. Two hundred vaccines to county workers, jail staff, and the fire department. Seventy doses to two elderly care centers.
One hour left.
Every available medical professional (doctors, nurses, pharmacists) was called to man four pop-up vaccination sites across the county. The news blasted out on social media and by word of mouth.
Shots were given as fast as people could present arms. Despite the inevitable excitement and confusion, crowds were polite and cooperative.
By 1:30, only forty doses remained at a church vaccination site. Seniors were called to the front of the line.
In under two hours, every dose was given. Warp speed indeed.
Finicky shelf-life is the price we are currently paying for RNA vaccines that are an astounding 90-95% effective.
The problem of vaccine supply logistics is a problem as old as vaccines themselves.
In the eighteenth century, smallpox was a dreaded plague. If you managed not to die a horrid death, you were likely horribly scarred, and often left blind.
But – conventional wisdom said that if you caught a similar, but milder disease called cowpox, you were safe from deadly smallpox. As the name implies, people who worked closely with cows (like milkmaids) often contracted cowpox. Milkmaids were known to brag that they would never be “ugly and pockmarked” after experiencing a case of cowpox.
British physician Edward Jenner put two and two together in 1796. He took a bit of fluid from a blister of a local milkmaid who currently had cowpox. (In a curiously recorded historical detail, the infecting cow was named “Blossom”).
Jenner then scratched the cowpox fluid into the arm of his gardener’s 8-year-old son. The boy developed a mild case of cowpox, but nothing more. Afterwards, Jenner infected the boy with smallpox, and to everyone’s relief, the boy did not get sick.
Jenner’s procedure became known as “vaccination”, its root from the Latin word for cow – “vacca”. Thank you, Blossom!
Cowpox blister fluid (pus, actually) was a nineteenth century version of a vaccine storage and distribution problem. You could easily vaccinate those living near a cowpox outbreak, but cowpox blister fluid doesn’t travel well.
The fluid dried up and inactivated before it could be transported across even small distances.
From the sixteenth through the nineteenth centuries, smallpox decimated the western hemisphere, carried there by European conquerors and settlers.
Spanish colonies world-wide were suffering from smallpox. But cowpox fluid didn’t survive a short trip, much less one across the globe.
IN 1803, a Spanish physician, Francisco Xavier de Balmis, organized a shocking expedition. Twenty-two orphaned boys, ages three to nine, were put on a ship bound for the Americas.
At the beginning of the trip, two boys were vaccinated with cowpox blister fluid. When they blistered, two more boys were vaccinated with the fluid. This process continued throughout the voyage, two by two, with the hope that at least one boy would arrive in the Americas with nice fluid-filled cowpox blisters.
The twenty-two orphan boys were a living supply chain of vaccine.
As it turns out, only one boy had a single fluid-filled cowpox blister when the expedition arrived in the Americas. Still, it was enough. The chain of vaccinations propagated from that one boy resulted in the vaccination of thousands.
The twenty-two Spanish orphans were adopted by Mexican families. In turn, twenty-six Mexican families “lent” their sons to continue carrying the vaccine to the Philippines and China.
After circling the globe to deliver vaccine, Balmis remained committed to carrying smallpox vaccine across the world.
May we be as resolute in vaccinating our modern population.
My husband was recently selected to be a vaccinator for Covid-19. Watch this space! I am excited to document the launch of a historic vaccine in his local medical practice.
It began with an application to the Texas Department of State Health Services. First the basics – are you a licensed physician in Texas? Where is your practice? What is the size of your practice?
Then more details: what kind of refrigeration and freezer equipment is on the premises? How many vials of vaccine can you accommodate? (He’s requested an initial 300 doses)
Both the Moderna and the Pfizer vaccines must be transported and stored at very low temperatures. My husband was required to purchase a special device for his refrigerator, a device designed to constantly record the temperature at specific intervals. The data can then be uploaded and analyzed to insure the “cold chain” has not been broken.
He doesn’t know at this point which vaccine (Moderna or Pfizer) will be shipped to him.
The final step in approval was an agreement to honor the directives:
• Do you agree not to charge patients for the vaccine?
• Do you agree to abide by priority guidelines and to honor the criteria regarding who should be vaccinated first?
Approval was granted Friday, December 4. Stay tuned!
In just a just matter of weeks, the first publicly offered vaccines will arrive across the U.S. at “warp speed”.
Understand: a vaccine roll-out is not an instant, get-out-of-jail-free, burn your masks and breathe on your neighbor free-for-all.
But it’s a start.
A wonderful, excellent, science-y start.
What to expect after your vaccination:
Essentially 100% of those vaccinated will have side effects following the jab. For the vast majority of us, that means pain at the injection site, a little swelling, and some redness.
A few people will have more intense side-effects, including fever, muscle pain, joint pain, headache, and fatigue. Side effects are temporary, usually lasting only a day or two.
Still, a sore arm and feeling a bit crummy for a day is a small price to pay to rein in an infection that can damage hearts and lungs and is lethal in 2% of diagnosed cases (compare to the seasonal flu at 0.1%).
Drew Weissman, an immunologist whose research contributed to both the Moderna and Pfizer vaccines wants people to be informed: “This is what you need to expect. Take Tylenol and suck it up for a day.”
Side effects are temporary and normal and are an indication that your immune system has shifted into high gear as it prepares to fight a future Covid-19 infection.
Redness, heat, pain, and swelling are signs of inflammation – your body’s natural response to invasion or injury. Think about itchy allergy eyes, a sprained ankle, or even a splinter in your finger.
Both the Moderna and Pfizer vaccines use RNA molecules with the “recipe” for one of the protein spikes on a COVID-19 virus. The RNA enters your muscle cells, and your cells use the “recipe” to churn out spike proteins – perfectly harmless proteins that cannot make you sick.
Fun fact – the spike proteins are constructed with raw materials found in your own, actual cells. The vaccine delivers the instructions, but the spike proteins are home-grown.
After the RNA recipe has been used a few times to cook up some spike proteins, the cell breaks down the RNA molecule and destroys it, Mission Impossible-style.
Your immune system learns to identify and remember the spike proteins and, in the future, will attack anything presenting the proteins (like an actual COVID-19 virus).
Inflammation is the result of this identification and learning process, thus the “side-effects” of a vaccine.
Both the Pfizer and the Moderna vaccines require a booster, given either three or four weeks after the first vaccine. Full effectiveness occurs about two weeks after the booster. What is unknown at this point is how long this immunity lasts.
On the horizon: using similar RNA therapy to trigger the body’s immune response to fight cancer.
What the vaccine does not do:
RNA vaccines cannot give you Covid-19. You cannot “shed” viruses to others following vaccination with an RNA vaccine. The vaccines do not contain actual viruses, killed or weakened or in any form.
RNA vaccines do not interfere or even encounter your own DNA.
DNA is in the nucleus of the cell. Protein construction occurs outside the nucleus, in the watery cytoplasm filling the cell. The RNA molecules delivered by the vaccine stay out in the cytoplasm because that’s where the raw materials needed to build the spike protein are found.
What about 20 years from now? What if the vaccine causes some future side effect? Again, an RNA molecule is very short-lived. Your cells destroy the RNA molecules shortly after they are used.
Would you like to find your place in line? Here’s a link for a handy-dandy tool that lets you estimate your place in the vaccine line.
I, for instance, am in line behind 23.0 million people across the United States.
I’m behind 1.9 million in Texas.
In Denton County, I’m behind 31,800.
If the line in Texas was represented by about 100 people, I’d be standing 24th in line.
Just in time for your Thanksgiving dinner (live or zoomed) or those fun holiday social media debates, I’ve made a little vaccine cheat sheet!
Three top vaccine contenders recently released phase three results: Pfizer/BioNTech, Moderna, and AstraZeneca/Oxford University.
All three studies meet the gold standard of science research: huge study groups, randomly assigned and double-blinded trials. In a double-blind trial, neither the study groups nor the people running the trial know if a volunteer receives a placebo or the actual vaccine.
All three of the first-out-of-the-gate vaccines are bioengineered. All three use genetic information to teach the immune system to attack the COVID-19 virus.
The Pfizer and Moderna vaccines are very similar, so we’ll start with them.
How Do They Work?
Both vaccines use a molecule of RNA, coated in an oily micro-bubble.
RNA is closely related to DNA, the molecule that carries the genetic code. When our cells need to make something (like a protein), a copy of the DNA gene for that protein is made on an RNA molecule.
Think of it this way: grandma’s cookbook contains all her recipes. You make a copy of one cookie recipe on a notecard and carry it back home, where you create the cookies. DNA is the cookbook; RNA is the notecard.
Both the Pfizer and the Moderna vaccines use RNA with the “recipe” for one of the protein spikes on the COVID-19 virus.
When injected, the oily micro-bubble fuses with a muscle cell. The cell uses the RNA “recipe” to make spike proteins, which are released into the body.
A spike protein alone won’t make you sick, but it will teach your body to attack anything presenting the protein – like an actual COVID-19 virus.
Although RNA vaccines have been studied for years and are approved for animal use, if approved, these vaccines would be the first for human use.
Do They Work?
The Pfizer vaccine was reported to be 90% effective and the Moderna vaccine 94.5% effective.
What does that mean in actual humans?
In the Moderna study, for example, 95 of the 30,000 volunteers got sick with COVID. Of the 95 sick people, ninety people received the placebo and only five received the vaccine, giving us an effectiveness rate of 94.5%.
An especially promising bit of news is that the five who got the vaccine and also got sick experienced only minor symptoms.
Severe symptoms were only found among the 90 people who got the placebo. This finding suggests that Moderna’s vaccine reduces the severity of disease in vaccinated people who still get sick.
To put a 90-95% effectiveness rate in perspective: in order for the FDA to consider a vaccine for use, it must demonstrate a 50% efficacy rate. Seasonal flu vaccines are 40-60 % effective. The measles vaccine is 97% effective.
Are They Safe?
Neither the Pfizer trial (44,000 participants) nor the Moderna trial (30,000 participants) uncovered any serious side effects. Both studies included volunteers of all ages and multiple ethnicities. But research doesn’t stop there. Safety studies continue as vaccines are rolled out to the general population.
Before launching their large phase three study, Pfizer tried out four versions of their vaccine in smaller groups. Pfizer selected the version that produced the fewest cases of mild and moderate side effects, such as fever and fatigue.
Once Approved, How Will the Vaccines be Distributed?
Gus Perna is the army general in charge of “Operation Warp Speed”, the plan to distribute enough vaccine for 300 million Americans in the most timely and efficient way. General Perna is an army logistics expert. (Check out Perna’s “60 Minutes” interview on November 6 for the details).
A problem to be solved with both the Pfizer and the Moderna vaccines is transportation and storage.
Pfizer’s vaccine needs to be really cold, stored at -112 degrees Fahrenheit. Pfizer is making special ultra-cold shipping boxes and storage containers for use until the vaccines are given. (For reference, your home freezer is 0 degrees Fahrenheit).
Moderna’s vaccine is a little less finicky, requiring “only” -4 degrees Fahrenheit. Additionally, Moderna’s can be stored in a regular refrigerator for 30 days after shipping.
The latest vaccine announcement comes from AstraZeneca and Oxford University.
How Does it Work?
Although the AstraZeneca vaccine is also bioengineered, it differs in delivery from the other two. The AstraZeneca vaccine uses a “vector” – a biological delivery truck – to deliver the genetic information needed to teach the immune system how to fight the actual COVID-19 virus.
The vector used is an adenovirus. This adenovirus causes colds in chimpanzees but is harmless to humans.
The adenovirus’ DNA is modified to contain the code for a COVID-19 spike protein. The adenovirus given in the vaccine “infects” human cells, delivering the gene for the spike protein. The cells in turn churn out the spike protein.
And just as with the other two vaccines, the spike protein teaches your system to fight future infections by the actual virus.
Adenovirus vaccines have been studied for decades, and European regulators recently approved a Johnson & Johnson adenovirus vaccine for Ebola.
Does it Work?
The AstraZenaca vaccine is reported to be about 70% effective. During the phase three trial, two versions were used. One version was 62% effective, one was 90% effective, for an average of 70%.
Is this enough data for AstraZeneca to ask for FDA emergency authorization? We don’t know yet.
Is it Safe?
AstraZeneca’s phase three trial was briefly halted due to possible reactions by two volunteers. However, the symptoms were found not to be directly related to the vaccine and the trials resumed.
That’s your cheat sheet for the first three vaccines.
So, what’s next?
Mark your calendars for December 10, 2020. Pfizer’s vaccine is on the FDA’s docket for emergency authorization consideration. If approved, get in line – healthcare workers, you’re first.
Regardless of your Thanksgiving dinner plans, consider this lovely little prayer, penned by Amanda Held Opelt, sister of Rachel Held Evans:
“These vaccines represent the tireless work by scientists & researchers who have already led lives of rigorous study and discipline. Lord, for these women & men, many of whose names we may never know, we give thanks.”
The hospital ward had beds for as many as fifty children.
Dr. Banting and his associate quietly stepped inside. Bed after bed was occupied by a child, comatose and dying from diabetic ketoacidosis. Grieving parents sat bedside, awaiting the inevitable.
The year was 1922. Medical researchers Fredrick Banting and his assistant Charles Best had been studying type 1 diabetes for the past two years. Using dogs, Banting and Best isolated insulin and treated (induced) diabetes in the animals.
We’ve known about type 1 diabetes for centuries. The condition is well documented in ancient Egyptian, Hindu, and Chinese medical records. Aretaeus of Cappadocia, a second-century Greek physician, described diabetes as “the melting down of flesh and limbs into urine”.
When the pancreas no longer produces insulin, people with type 1 diabetes cannot metabolize carbohydrates. Without insulin, patients waste away and suffer greatly, no matter how much they eat. The death rate for type 1 diabetes, prior to insulin therapy, was 100%.
By the nineteenth century, we realized the role of carbohydrate metabolism in diabetes. Doctors attempted to control the disease with diet – prescribing only meat or fat for suffering children. On severely calorie-restricted diets, children lost weight and were critically malnourished.
Still, instead of death in a few weeks, children might survive a year.
Encouraged by their success with dogs in the lab, Banting and Best injected an emaciated 14-year-old boy with insulin obtained from a cow in January 1922. Daily injections over the next twelve days dropped his blood sugar until it was no longer detectable in his urine.
Soon after, Banting and Best walked into the solemn and quiet ward in a Toronto hospital, filled with comatose children. Banting and Best went bed to bed and injected each child with insulin.
As they injected the last child, the first child woke up.
One by one, all the children awoke from coma.
A room filled with impending death became a place of hope.
The 1923 Nobel Prize in Medicine was awarded to Fredrick Banting and John Macleod, in whose laboratory Banting and Best worked. Banting shared his prize with Best.
The Eli Lilly Company improved the process for obtaining insulin from animals and sold the patent to the University of Toronto for $1.00.
For the next six decades, insulin for human use was obtained from the pancreases of pigs and cows, a difficult and expensive process.
Everything changed in 1982. Using new genetic technology, the gene for making insulin was snipped out of human DNA and inserted into the DNA of a bacteria. The new transgenic bacteria were cloned. Entrepreneur Bob Swanson and his partner biologist Herbert Boyer grew vats and vats of the bacterial cells, all of which churned out huge quantities of insulin.
For the first time, human insulin was produced in enormous quantities and made available to people with diabetes.
Human insulin was the first genetically engineered drug approved by the FDA. Today, hundreds of medical conditions are treated with recombinant DNA drugs.
Objections to genetically modified organisms (GMOs) play on fears of the unknown. All too often, biotechnology is rejected without fully understanding the underlying science.
Fear of GMO technology results in absurd nonsense like the marketing of “NON-GMO” labeled salt. Salt contains no DNA to modify.
The top five contenders in the race for a COVID-19 vaccine use genetic information to teach our immune system to fight a viral infection. Already the anti-GMO movement is joining forces with anti-vaccine groups. Already vaccines developed using biotechnology are suspect.
Drugs developed using biotechnology have saved countless lives. A new generation of bioengineered vaccines are ready to join to the fight.
November is National Diabetes Awareness month.
Thank you, Drs. Banting and Best.
And thanks to the pioneers in recombinant drug therapies.
They escaped from Alcatraz, exploded a toilet, drank mentos and Diet Coke at the same time, and lived to tell the tale. They even proved there was room for Jack as well as Rose on that plank of wood.
Discovery Channel’s long-running MythBusters put questions, myths, and urban legends to the test. Sometimes there was truth, sometimes a bit of truth, and often the myth was busted (no, your stomach will not explode if you drink Coke and Mentos at the same time).
INTRODUCING: Science Meme Busters! I can’t bust them all, but I’ll be on the lookout for the good ones!
Memes make the rounds on social media, especially science memes. Sometimes photos with clever captions, sometimes cut-and-paste stories that begin with “I copied this from someone else” or “copied and shared from a friend”.
Making the rounds lately are the thoughts of an anonymous “ER nurse” regarding “diverse opinions” about Covid-19.
So much to bust in this meme, but for now, I’ll focus here:
Anyone out there who can tell me what our end game is with the covid19? . . . Is it a vaccine? . . .It took 25 years for a chicken pox vaccine to be developed.” “Do you really think people will flock to get a fast tracked, quickly tested vaccine, whose long term side effects and overall efficacy are anyone's best guess?
Vaccines train our immune system to recognize and fight invading pathogens. Before the 20th century, this could be an effective but often dangerous practice.
For centuries, doctors rubbed scabs from smallpox victims into a scratch on the arm of a healthy person, a process called “variolation”. A single smallpox blister would form, heal, and the variolated person was immune to smallpox . . . hopefully.
Sometimes the variolated person developed smallpox. Two percent of variolated people died. Still, two percent is a far cry from the 30% death rate from natural smallpox infection.
Weighing the risks, many opted for smallpox variolation when it was available. George Washington ordered the variolation of his troops at the height of the American Revolution.
No one knew why variolation (sometimes) worked. But by the 20th century, we knew about viruses and we fixed our attention on them.
We looked for a safer way to train the immune system using vaccines containing inactivated or weakened viruses.
When vaccines for diseases like measles, mumps, and chickenpox were developed, researchers weakened viruses by systematically growing them in a variety of cultures. Viruses were forced to grow for hundreds of generations in a hodgepodge of human and animal cells. As the viruses adapted to ever-changing environments, they became less dangerous to humans.
As you can image, it was time-consuming to grow strains of disabled viruses. Following the creation of a disabled strain, vaccines were developed, then tested – all time-consuming processes.
We aren’t starting from scratch with Covid19. This is the 21st century and we aren’t just figuring out this whole vaccine thing.
In 2020, we have more technology in our arsenal. In our age of modern genetics, the five top candidates for a Covid19 vaccine use information to teach our immune system, not the actual Covid19 virus.
Two of the top contenders use a copy of a gene that makes one of the protein spikes on the corona virus. The vaccine delivers the genetic instructions, and the body responds by using the instructions to make the spike protein.
The spike protein alone won’t make you sick. BUT – the presence of the protein teaches your immune system to recognize and destroy anything presenting the protein – including an entire Covid19 virus.
The remaining top contenders use other versions of delivering genetic instructions for a single Covid19 protein.
Instead of months (and more) of transferring viruses from culture to culture, the genetic code for a protein can be read almost immediately.
We can make an experimental batch of vaccine in a week.
The mysterious and anonymous “nurse” in this meme cites the years needed to develop the chickenpox vaccine and worries about the “fast-tracking” of a Covid19 vaccine. Should we fear a vaccine developed under a program termed “Operation Warp Speed”?
The unprecedented speed of a Covid19 vaccine is not due to fast-tracking and corner-cutting in safety and effectiveness testing.
The “speed” refers to the manufacturing process. While all the long phases of safety trials are occurring, the most promising vaccines are being manufactured on an industrial scale. Usually, vaccines aren’t manufactured until after the trials.
In order to speed things up, doses of the promising vaccines are already being made. If all of the phase trials show a vaccine to be safe and effective, we won’t have to wait months to manufacture it.
On the other hand, we are possibly manufacturing doses that will never be used.
The risk in Operation Warp Speed is financial, not safety.
Located halfway between London’s posh Barbican theater district and the famed Smithfield Market is a plot of land with a gruesome past. Excavation in the 1980s revealed bodies – loads and loads of bodies. So far, 600 bodies have been catalogued, but there are probably at least 2,400 total.
The year was 1348, and after devastating the continent, the Black Death had arrived in England. By 1350, one-third of Britain was dead of plague.
At the height of the plague in London, 200 people per day were buried in the mass grave known as “East Smithfield”. London’s churchyards could not accommodate such a colossal demand, so the city created the five-acre burial pit. Hastily, the dead were buried en masse, some neatly lined up, others tossed in haphazardly.
The plague struck hard and fast in Britain and across Europe, and in a short time decimated the population.
Prevention measures (as best as possible in the pre-scientific, pre-modern epidemiology days of the fourteenth century) were practiced. In order to avoid the “bad air” thought to spread plague, doors and windows were shuttered, suspending easy access to family, friends, and neighbors. Households with plague were quarantined.
But for the survivors, the story took a bit of an uptick.
For generations after the plague years, survivors were generally healthier and lived longer than did the general population pre-plague.
Interestingly, modern genetic studies suggest that some survivors had innate genetic resistance to the plague or to its fatality.
However, there was probably an additional environmental factor.
As much as half the population died in some areas. With the weak winnowed out, survivors had access to more food, more meat, more and better bread. After four years of lockdowns and quarantines, survivors were ready to return to life as usual.
Blinking in the plague-free sunlight, survivors emerged, ready to get on with life, with socialization, with commerce.
Centuries later, we, too, are weary of lockdowns. Our modern plague is world-wide, and the death and damage rates are frightening. Thankfully due to modern therapeutics, we are not looking at a death rate of one-third of our population.
Still, we are tired of it all. In the decade (it seems) of 2020, we have endured multiple claims of those who offer shortcuts to our misery: the “Plandemic” video, America’s Frontline Doctors’ white-coated press conference on the steps of the Supreme Court, and the Yale doctor with his hydroxychloroquine conspiracy.
After their fifteen minutes of fame, each faded, answered by evidence and the scientific method.
Enter the ostentatiously titled “Great Barrington Declaration”, signed on October 4 and currently muscling its way into the headlines.
The document argues that Covid-19 should be allowed to spread uncontrolled among the healthy, while presumably protecting the vulnerable. The result of such a strategy (according to the document) would be “herd immunity” without the use of a vaccine.
In the last few days, heavy hitters in the field of epidemiology and infectious disease have weighed in, including Anthony Fauci (“total nonsense”) and the prestigious Lancet medical journal (“a dangerous fallacy unsupported by scientific evidence.”) The director of the World Health Organization called the plan “scientifically and ethically problematic.”
Sponsored by a Libertarian think tank, The Great Barrington Declaration is penned by three scientists associated with big-name universities. The Declaration’s website claims tens of thousands of online signatures from medical practitioners and public health scientists, but the signees were recently made anonymous after too many Fakey McFakenames were found on the rolls.
In cases of viral diseases for which we have a vaccine (like measles), it’s true: we rely on herd immunity to protect the very young, the immunocompromised, and the few who (unknowingly) do not mount an immune response following a vaccine. But in the case of measles, herd immunity is not achieved by deadly disease sweeping through an entire population, killing and maiming many but leaving a few survivors with resistance. With measles, herd immunity is achieved without the devasting effects of the actual disease.
The Great Barrington Declaration is problematic scientifically:
A pandemic control strategy that relies on herd immunity is seriously flawed and is not supported in scientific literature.
Uncontrolled spread of Covid-19, even in a young population, increases the risk of death and long-term damage.
At this point, we do not know how long natural immunity to Covid-19 lasts. Relying on natural herd immunity could result in repeated epidemics, as we saw before the advent of vaccination.
The Great Barrington Declaration is problematic ethically:
Uncontrolled spread of Covid-19 increases the risk to frontline health workers, already at a heightened risk.
The Great Barrington Declaration advocates protecting vulnerable populations, but how do we define “vulnerable”? So, we isolate all the sick and elderly in nursing homes. What about people with unhealthy BMIs? What about people living in crowded homes with multiple generations of family? What about people with limited access to healthcare? That’s a lot of people to isolate while we let a virus run free.
Marginalized communities are at a higher risk, and many are young, the demographic in which The Great Barrington Declaration would allow the virus to run rampant. Are we willing to winnow the marginalized in pursuit of a shortcut to social normalcy?
No one wants endless lockdowns and the destruction of the economy. Social safety, common sense, increased and affordable testing, contact tracing, and mask-wearing are not draconian.
It’s not all or nothing.
I visited East Smithfield in London in 2016. Our “London Plague” tour guide lead us through the city with a rat on a stick.
Seen this weekend in my local Kroger: A Covid-19 mask, plague-style.