Category: Current Affairs
We are just now evaluating vaccines based on the initial Omicron variant, which emerged seven months ago. They are only a moderate improvement on the status quo, in part because we have gone through several iterations of the variant since then. Because they are probably better but might not be that much better, Offit’s advice is even more delay while we study even more.
We have basically enshrined a process that guarantees vaccine development will be far behind the progress of the virus, the bad process itself being its own self fulfilling prophecy because the lag ensures the results will be worse.
The capability of mRNA vaccines to be quickly adapted to the disease is not being leveraged.
That is from Dan1111. And this is from Naveen K:
The Left in the last two weeks has said they’re for imposing mask mandates (coming soon in LA county) and Fauci restated his support for masks last week. All this while Biden WH saying Biden getting COVID isn’t a big deal.
It is very real, just look around the world. Even Mario Draghi is on the way out. Here is one take from Adrian Wooldridge at Bloomberg:
Leadership is most vital during a period of transition from one order to another. We are certainly in such a period now — not only from the neoliberal order to something much darker but also to a new era of smart machines — yet so far leadership is lacking. We call for leaders who are equal to the times, but nobody answers.
Kissinger offers two explanations for this troubling silence. The first lies in the evolution of meritocracy. (Full disclosure: He mentions a book I have written on this subject). The six leaders were all born outside the pale of the aristocratic elite that had hitherto dominated politics, and particularly foreign policy: Adenauer and Sadat were the sons of clerks, Thatcher and Nixon were the children of storekeepers, Lee’s parents were downwardly mobile. But theirs was a meritocracy with an aristocratic flavor. They went to elite schools and universities that provided an education in human excellence rather than just passing tests. In rubbing shoulders with members of the old elite, they absorbed some of its ethic of noblesse oblige (“For unto whomsoever much is given, of him shall be much required”) as well as its distaste for populism. Hence Lee’s recurring references to “Junzi” (Confucian gentlemen) and de Gaulle’s striving to become a “man of character.” They believed in history, tradition and, in most cases, God.
The world has become much more meritocratic since Kissinger’s six made their careers, not least when it comes to women and ethnic minorities. But the dilution of the aristocratic element in the mix may also have removed some of the grit that produced the pearl of leadership: Schools have given up providing an education in human excellence — the very idea would be triggering! — and ambitious young people speak less of obligation than of self-expression or personal advancement. The bonds of character and duty that once bound leaders to their people are dissolving.
There are further arguments — much more in fact — at the link. And here is an ngram on “leadership.”
He is a leading foreign policy expert, and I will be doing a Conversation with him. Here is from Wikipedia:
Walter Russell Mead (born June 12, 1952) is an American academic. He is the James Clarke Chace Professor of Foreign Affairs and Humanities at Bard College and taught American foreign policy at Yale University. He was also the editor-at-large of The American Interest magazine. Mead is a columnist for The Wall Street Journal, a scholar at the Hudson Institute, and a book reviewer for Foreign Affairs, the quarterly foreign policy journal published by the Council on Foreign Relations.
So what should I ask him?
The rollout of the Monkeypox vaccine hasn’t been without problems but we are making fewer mistakes. I feel pretty good that my work on first doses first for COVID (as well as that of Tyler, Michael Mina, Robert Wachter and others) pushed the Overton window. This is good to see.
That is the topic of my latest Bloomberg column. I am ultimately optimistic, but let me present the case for the negative:
Yet those positives have been in place for a while, and the results are less than earth-shattering. By World Bank estimates, Colombia has a per capita income of slightly more than $16,000, using purchasing power parity standards. For purposes of comparison, Mexico comes in at slightly over $20,000. Argentina is considered to have been an economic failure since the Peronist years, but still has a per capita income exceeding $22,000.
Also troubling is the country’s export profile. After fossil fuels, which have a limited future, the country’s leading exports are coffee, gems and precious metals. None of these is large enough or sophisticated enough or training enough quality labor to push the nation over the top. When it comes to complex manufacturing, the country is lagging well behind Mexico and Brazil, much less South Korea.
A pessimistic view of Colombia would cite the country’s very different geographic regions that have never seen full economic or even political unification. The lack of a fully developed nation-state has been reflected in the country’s ongoing troubles with guerrillas and drug lords. The major urban centers of Bogotá and Medellín are both deep in the interior, surrounded by mountains, and unable to take advantage of major navigable rivers. There is no world-class port or harbor, and except for its connection to the US, the country is inward-looking and has attracted relatively few immigrants, recent Venezuelan refugees aside. The Amazon cuts off Colombia from much of the rest of South America. De facto Colombia has no richer neighbor to pull it up by its bootstraps, Panama being much too small and most of Brazil being too distant. Colombia’s problems also include a recent uptick in troubles with former guerrillas.
I look forward to my next visit to the country…
Via Mario A. And here is for the region as a whole:
According to the OECD, only 5 per cent of Colombians pay income tax. Revenue from personal income tax is worth just 1.2 per cent of gross domestic product compared to an OECD average of 8.1 per cent.
Taxes on businesses, on the other hand, are relatively high. The outgoing rightwing government of Iván Duque initially cut the corporate tax rate from 33 to 31 per cent. But when the coronavirus pandemic hit, followed by prolonged street protests against his rule, he was forced to raise it to 35 per cent, its highest level in 15 years and above the Latin American average.
Here is more from the FT. Note that the president-elect, Petro, actually is planning on cutting taxes on business, though he is proposing a wealth tax on individuals as well.
No political party ever ran for election on the promise to bring back the landlords. None of our leaders ever said that the problem with late 20th century Ireland was that too few people were paying rent.
And yet, this shift back towards landlordism didn’t happen by accident. It has been engineered by the State and partly paid for by the taxpayer.
It is the State that created and shaped this change. It pays all or most of the rent to landlords for 113,000 households. Between 2001 and 2020 governments have spent €12.5 billion to support the private rental market.
The consequent shift is a remarkable exercise in social engineering. Renting has been made more and more “normal” for each succeeding generation.
A recent ESRI report tells us that fewer than 20 per cent of Irish people born in the 1950s or 1960s lived in rented accommodation in their mid-thirties. For those born in the 1970s this rises to just over 30 per cent. For those born in the 1980s it’s over 40 per cent.
These figures are, naturally, mirrored on the other side by a dramatic decline in home ownership among young people. In 2004, 60 per cent of those aged 25-44 owned their own homes. By 2015 that had halved to 30 per cent.
Ukraine’s budget crisis has become acute because of a slump in tax revenues and customs duties since the invasion began almost five months ago together with higher war spending.
A halt to grain and steel exports has deprived Kyiv of foreign currency earnings. Ukraine is being forced to burn through its foreign exchange reserves at an accelerating pace, as the central bank purchases government bonds to plug its financing gap.
…The finance ministry said its assessment of the gap was still $5bn a month but even that was way more than western capitals had so far provided.
…The fiscal strains are showing more broadly. Naftogaz, the state-owned energy company, on Tuesday asked holders of $1.5bn of its bonds to accept a delay in payments as it seeks to preserve cash for purchasing gas. It would amount to the first default by a Ukrainian state entity since the war began.
Here is more from the FT.
Monkeypox isn’t in the same category of risk that COVID was before vaccines but it’s a significant risk, especially in some populations, and it’s a test of how much we have learned. The answer is not bloody much. Here’s James Walsh in NYMag:
As monkeypox cases have ticked up nationwide, the White House and federal agencies have repeatedly assured the public that millions of vaccine doses will be distributed to at-risk populations before the end of the year. Yet since the World Health Organization announced the global monkeypox outbreak in May, only tens of thousands of shots have been administered in the U.S. The slow start is due, at least in part, to the fact that 1.1 million doses have been stored in a Denmark pharmaceutical facility while the Food and Drug Administration has taken almost two months to approve their release here, according to people familiar with the situation. FDA officials only began to inspect the facility last week. The lag time, public-health experts say, is indicative of the federal government’s lackadaisical approach to a growing public-health emergency.
…It’s unclear why the FDA took so long to send inspectors to Denmark. The agency regularly conducted virtual inspections of drug facilities early in the COVID-19 pandemic, according to the agency’s guidance, and public-health activists are demanding answers. “Members of at risk communities are being turned away from monkeypox vaccination because these vaccines are not available in sufficient quantity in the U.S., but instead sitting in freezers in Denmark,” members of the advocacy group PrEP4All and Partners in Health wrote in a letter to federal officials overseeing the outbreak response last week.
Compounding their frustrations was the FDA’s refusal to accept an inspection done last year by its counterpart, the European Medicines Agency, which deemed the company’s facility in compliance with the FDA’s own standards.
“The FDA does not grant reciprocity for EMA authorization of any vaccines, for monkeypox or other diseases,” a spokesperson for the FDA said in a statement.
Is there anyone in the United States who is saying, “I am at risk of Monkeypox and I want the vaccine but I don’t trust the European Medicines Agency to run the inspection. I’d rather wait for the FDA!” I don’t think so. James Krellenstein, an activist on this issue, asks:
“Why were the Europeans able to inspect this plant a year ago, ensuring these doses can be used in Europe and the Biden Administration didn’t do the same,” he added. “The FDA is making a judgment that they’d rather let gay people remain unvaccinated for weeks and weeks and weeks than trust the European certification process.”
Many people want to be vaccinated:
New York City has received just 7,000 doses from the federal government amid the national vaccine shortage. Meanwhile, the city Department of Health and Mental Hygiene’s appointment booking system has failed to keep up with the high demand for the shots — most recently on Wednesday.
…The mounting frustrations left health officials and Mayor Eric Adams on the defensive, pushing back against comparisons to New York’s struggles during the early days of the coronavirus vaccine, which was beset by computer glitches and supply shortages.
Addendum: If you are not furious already–and you should be–remember that during COVID the FDA suspended factory inspections around the world creating shortages of life-saving cancer drugs and other pharmaceuticals. As I wrote then “Grocery store workers are working, meat packers are working, hell, bars and restaurants are open in many parts of the country but FDA inspectors aren’t inspecting. It boggles the mind.”
Hat tip: Josh Barro.
Photo Credit: Nigeria Centre for Disease Control.
More specifically, according to data provided to The Times by Express Scripts, a pharmacy benefits manager, prescriptions across three categories of mental health medications — depression, anxiety and A.D.H.D. — have all risen since the pandemic began. But they have done so unevenly, telling a different story for each age group and each class of medication.
Here is more from the NYT, depressing throughout.
It's over for nuclear in Germany. The SDP-Green coalition has won a vote in the Bundestag backing more coal burning so that the three remaining nuclear plants can be switched off as planned this year. Climate targets may have to be abandoned as a result.https://t.co/OAmexhAuUR
— Mark Lynas (@mark_lynas) July 8, 2022
Operation Warp Speed produced a new vaccine for a novel virus in record time but when Operation Warp Speed was disbanded by the Biden administration, vaccine research and development slowed from warp speed to impulse power. It’s ridiculous that it is taking longer to develop and deploy tweaks to the mRNA vaccines to deal with new variants than it took to develop the original vaccines from scratch. By the time we get an Omicron-specific vaccine that variant will have disappeared. This is no way to run a civilization.
We should be investing in a universal vaccine for all sarbecoviruses (of which SARS-COV-II is a member) and, as I have long argued (and here) a nasal vaccine. We need not exaggerate, for the vaccinated the dangers are no longer acute, but we should be better prepared for future variants and the savings from less sickness alone easily trump the costs. Indeed, the issue isn’t even so much the cost as the need to coordinate regulatory agencies, as OWS did, to speed approvals and reduce bureaucracy.
Despite excellent technology and promising early results in animal models, we estimate that the very earliest we will have access to these vaccines in humans is 2024. These groups need to run primate trials, then run human clinical trials, and then ramp manufacturing and distribution. Beyond having to jump through a lot of hoops, we’ve observed that they’re frequently tripped up by stupid things outside of their control, any one of which may hold their work back by months. (One group’s monkeys have been delayed by US Customs, which will push the start of their primate trial back ‘till September. Another is struggling to obtain necessary adjuvants. Multiple groups are unable to get access to current mRNA vaccines for research purposes because of legal barriers.) All groups we’ve interacted with are underfunded compared to what would be ideal.
Broadly speaking, the holdups involve some combination of logistical challenges and regulatory requirements, and the intersection between both. (You don’t in principle have to run a primate trial, but the FDA makes it harder to run a human trial if you don’t. You don’t in principle need to use “acute infection” as a trial endpoint; you could also use neutralizing antibody titers, which would be much faster and simpler.)
To speed things up:
- We should lower the barrier for human clinical trials and use simpler endpoints. For many vaccine candidates, we could run human trials concurrent with primate trials (once basic safety data has been obtained). In humans, we don’t need to repeat Phase I trials for platforms that have already been validated and derisked. (In this vein, the FDA’s recent announcement about not requiring trials for updated platforms was encouraging.)
- We should help these groups to scale manufacturing faster. Operation Warp Speed itself cost $10 billion; a second incarnation, with a tenth of that budget, could almost certainly accomplish a great deal.
…In our view it is probably true that, with competent execution, we could roll out pan-variant COVID vaccines before the end of 2022. Actually making that happen would require significant and coordinated logistical, regulatory, and administrative action. However, it would by no means be impossible. Not having pan-variant vaccines in 2022 is best thought of as a choice.
That is the topic of my latest Bloomberg column. The country suddenly faces many problems at once:
…extremely high energy prices, the need to bail out some of its energy firms, the conflict in Ukraine and the resulting promise to boost defense spending, and possible troubles with Italy in the Eurozone over rising borrowing costs. Germany is either going to do very, very poorly, or will muddle through and manage a major turnaround. I would bet on the latter.
And here is another part of the argument:
And then there is what may be Germany’s biggest problem: complacency. In the last 20 years Germany’s primary education system has had a mixed performance, albeit with some improvements, and its infrastructure is no longer perceived as so efficient or high quality. Yet reform was not imperative, partly because things were going OK enough in Germany.
There is a chance that the current crisis will jolt Germany out of its passivity. Throughout history Germany has managed to reverse some very bad situations, as it did after the devastations of the Napoleonic wars and World War II.
Keep in mind that human capital is the most important determinant of national wealth, much more important than the flows reflected in the trade account in any given month or year. If German reforms boost the ability of the country to train students and to put its people to work, the long-run payoffs could be very high.
In general I have found that wealthy societies deal with “one-off” problems somewhat better than most observers expect in advance. I will be watching closely.
I am saddened and disturbed by the destruction of the Georgia Guidestones. The Guidestones, “America’s stonehenge,” were a set of six large, granite slabs, erected in 1980 and paid for by a mysterious group of unknown benefactors. The slabs were arranged precisely for astronomical reasons and contain inscriptions in multiple languages. On July 6, 2022 the Guidestones were blown up and then, what remained, was completely destroyed for apparent safety reasons.
The Guidestones were not a significant marker of cultural heritage, unlike the 1400 year old massive Buddhas of Bamiyan which were destroyed by the Taliban in 2001. Nevertheless, it is hard not to see the parallels between the destruction of the Guidestones and the Bamiyan Buddhas. Earlier this year Kandiss Taylor, a minor candidate for the 2022 Republican nomination for Governor of Georgia, made the destruction of the Guidestones one of her campaign pledges, claiming they were a Satanic evil. Thus, the destruction of the Guidestones was likely motivated by fears and hatred similar to those that motivated the destruction of the Buddhas. At the very least, an interesting art work, created at considerably expense by a group of public benefactors, was maliciously destroyed.
The Guidestones were meant to last for a thousand years and to offer guidance to humanity after a castrophe such as a nuclear war. The Guidestones lasted 42 years. It doesn’t bode well.