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kottke.org posts about Zeynep Tufekci

“Can We Do Twice as Many Vaccinations as We Thought?”

posted by Jason Kottke   Dec 18, 2020

In an opinion piece for the NY Times, Zeynep Tufekci and epidemiologist Michael Mina are urging for new trials of the Moderna and Pfizer/BioNTech Covid-19 vaccines to begin immediately to see how effective a single dose might be in preventing new infections. If the trials do indicate that a single dose works, that would effectively double the number of people we could vaccinate within a certain time period, saving countless lives in the US and worldwide.

Both vaccines are supposed to be administered in two doses, a prime and a booster, 21 days apart for Pfizer and 28 days for Moderna. However, in data provided to the F.D.A., there are clues for a tantalizing possibility: that even a single dose may provide significant levels of protection against the disease.

If that’s shown to be the case, this would be a game changer, allowing us to vaccinate up to twice the number of people and greatly alleviating the suffering not just in the United States, but also in countries where vaccine shortages may take years to resolve.

But to get there — to test this possibility — we must act fast and must quickly acquire more data.

For both vaccines, the sharp drop in disease in the vaccinated group started about 10 to 14 days after the first dose, before receiving the second. Moderna reported the initial dose to be 92.1 percent efficacious in preventing Covid-19 starting two weeks after the initial shot, when the immune system effects from the vaccine kick in, before the second injection on the 28th day

That raises the question of whether we should already be administrating only a single dose. But while the data is suggestive, it is also limited; important questions remain, and approval would require high standards and more trials.

The piece concludes: “The possibility of adding hundreds of millions to those who can be vaccinated immediately in the coming year is not something to be dismissed.”

Korean Study: Indoor SARS-CoV-2 Transmission from 21 Feet Away in Just 5 Minutes

posted by Jason Kottke   Dec 04, 2020

Zeynep Tufekci reports on a small study from Korea that has big implications on how we think about transmission of SARS-CoV-2. Scientists traced two cases back to a restaurant and discovered that transmission had occurred over quite a long distance in a very short period of time.

If you just want the results: one person (Case B) infected two other people (case A and C) from a distance away of 6.5 meters (~21 feet) and 4.8m (~15 feet). Case B and case A overlapped for just five minutes at quite a distance away. These people were well beyond the current 6 feet / 2 meter guidelines of CDC and much further than the current 3 feet / one meter distance advocated by the WHO. And they still transmitted the virus.

As Tufekci goes on to explain, the way they figured this out was quite clever: they contact traced, used CCTV footage from the restaurant, recreated the airflow in the space, and verified the transmission chain with genome sequencing. Here’s a seating diagram that shows the airflow in relation to where everyone was sitting:

seating diagram of a restaurant that shows how SARS-CoV-2 was transmitted across the room

Someone infecting another person 21 feet away in only five minutes while others who were closer for longer went uninfected is an extraordinary claim and they absolutely nailed it down. As Sherlock Holmes said: “Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth.” And the truth is that in some cases, the recommended 6 feet of distance indoors is not sufficient when people aren’t wearing masks. Airflow matters. Ventilation matters. Which way people are facing matters. How much people are talking/laughing/yelling/singing matters. Masks matter. 6 feet of distance does not confer magical protection. All that can make it tough to figure out if certain situations are safe or not, but for me it’s an easy calculation: absolutely no time indoors with other people not wearing masks. Period. As Tufekci concludes:

I think there are three broad lessons here. One, small data can be extremely illuminating. Two, air flow and talking seem to matter a great deal. Three, sadly, indoor dining and any activity where people are either singing or huffing and puffing (like a gym) indoors, especially with poor ventilation, clearly remains high risk.

Read her whole post — as she says, it’s “perhaps one of the finest examples of shoe-leather epidemiology I’ve seen since the beginning of the pandemic”.

“It’s Time to Hunker Down”

posted by Jason Kottke   Nov 16, 2020

Zeynep Tufekci says that a devastating third pandemic surge is upon us and that It’s Time to Hunker Down. She leads with the good news (vaccines, treatments, knowledge, testing capacity & quickness) but notes that with winter coming and a high baseline of cases from a summer not spent in preparation, now is the time to really knuckle down so that we can get to the finish line.

Whatever the causes, public-health experts knew a fall and winter wave was a high likelihood, and urged us to get ready.

But we did not.

The best way to prepare would have been to enter this phase with as few cases as possible. In exponential processes like epidemics, the baseline matters a great deal. Once the numbers are this large, it’s very easy for them to get much larger, very quickly — and they will. When we start with half a million confirmed cases a week, as we had in mid-October, it’s like a runaway train. Only a few weeks later, we are already at about 1 million cases a week, with no sign of slowing down.

Americans are reporting higher numbers of contacts compared with the spring, probably because of quarantine fatigue and confusing guidance. It’s hard to keep up a restricted life. But what we’re facing now isn’t forever.

It’s time to buckle up and lock ourselves down again, and to do so with fresh vigilance. Remember: We are barely nine or 10 months into this pandemic, and we have not experienced a full-blown fall or winter season. Everything that we may have done somewhat cautiously — and gotten away with — in summer may carry a higher risk now, because the conditions are different and the case baseline is much higher.

“America’s Next Authoritarian Will Be Much More Competent”

posted by Jason Kottke   Nov 09, 2020

Citing international precedent and America’s anti-majoritarian systems, Zeynep Tufekci argues that the next authoritarian who runs for President will be much more competent and dangerous.

The Electoral College and especially the Senate are anti-majoritarian institutions, and they can be combined with other efforts to subvert majority rule. Leaders and parties can engage in voter suppression and break norms with some degree of bipartisan cooperation across the government. In combination, these features allow for players to engage in a hardball kind of minority rule: Remember that no Republican president has won the popular vote since 2004, and that the Senate is structurally prone to domination by a minority. Yet Republicans have tremendous power. This dynamic occurs at the local level, too, where gerrymandering allows Republicans to inflate their representation in state legislatures.

The situation is a perfect setup, in other words, for a talented politician to run on Trumpism in 2024. A person without the eager Twitter fingers and greedy hotel chains, someone with a penchant for governing rather than golf. An individual who does not irritate everyone who doesn’t already like him, and someone whose wife looks at him adoringly instead of slapping his hand away too many times in public. Someone who isn’t on tape boasting about assaulting women, and who says the right things about military veterans. Someone who can send appropriate condolences about senators who die, instead of angering their state’s voters, as Trump did, perhaps to his detriment, in Arizona. A norm-subverting strongman who can create a durable majority and keep his coalition together to win more elections.

You should also read Tufekci’s related thread, where she responds to some comments and criticism of the piece.

This isn’t some rare thing that just happened because of weird circumstances. This is a playbook that works. This is a global playbook on the rise. This is a playbook found in America’s past, too. Realism is the true basis for hope.

We have to keep pushing to make sure no populist authoritarians ever get their hands on the Presidency again.

“This Overlooked Variable Is the Key to the Pandemic”

posted by Jason Kottke   Oct 02, 2020

Zeynep Tufekci says that we are paying too much attention to the R value of SARS-CoV-2 (basically the measure of its contagiousness) and not nearly enough attention to the k value (“whether a virus spreads in a steady manner or in big bursts, whereby one person infects many, all at once”).

There are COVID-19 incidents in which a single person likely infected 80 percent or more of the people in the room in just a few hours. But, at other times, COVID-19 can be surprisingly much less contagious. Overdispersion and super-spreading of this virus is found in research across the globe. A growing number of studies estimate that a majority of infected people may not infect a single other person. A recent paper found that in Hong Kong, which had extensive testing and contact tracing, about 19 percent of cases were responsible for 80 percent of transmission, while 69 percent of cases did not infect another person. This finding is not rare: Multiple studies from the beginning have suggested that as few as 10 to 20 percent of infected people may be responsible for as much as 80 to 90 percent of transmission, and that many people barely transmit it.

We’ve known, or at least suspected, this about SARS-CoV-2 for awhile now — I linked to two articles about superspreading back in May and June — but Tufekci says we have not adjusted our thinking about what that means for prevention. We should be avoiding superspreading environments/events (“Avoid Crowding, Indoors, low Ventilation, Close proximity, long Duration, Unmasked, Talking/singing/Yelling”), doing backwards contact tracing, and rapid testing.

In an overdispersed regime, identifying transmission events (someone infected someone else) is more important than identifying infected individuals. Consider an infected person and their 20 forward contacts-people they met since they got infected. Let’s say we test 10 of them with a cheap, rapid test and get our results back in an hour or two. This isn’t a great way to determine exactly who is sick out of that 10, because our test will miss some positives, but that’s fine for our purposes. If everyone is negative, we can act as if nobody is infected, because the test is pretty good at finding negatives. However, the moment we find a few transmissions, we know we may have a super-spreader event, and we can tell all 20 people to assume they are positive and to self-isolate-if there is one or two transmissions, it’s likely there’s more exactly because of the clustering behavior. Depending on age and other factors, we can test those people individually using PCR tests, which can pinpoint who is infected, or ask them all to wait it out.

Part of the problem is that dispersion and its effects aren’t all that intuitive.

Overdispersion makes it harder for us to absorb lessons from the world because it interferes with how we ordinarily think about cause and effect. For example, it means that events that result in spreading and non-spreading of the virus are asymmetric in their ability to inform us. Take the highly publicized case in Springfield, Missouri, in which two infected hairstylists, both of whom wore masks, continued to work with clients while symptomatic. It turns out that no apparent infections were found among the 139 exposed clients (67 were directly tested; the rest did not report getting sick). While there is a lot of evidence that masks are crucial in dampening transmission, that event alone wouldn’t tell us if masks work. In contrast, studying transmission, the rarer event, can be quite informative. Had those two hairstylists transmitted the virus to large numbers of people despite everyone wearing masks, it would be important evidence that, perhaps, masks aren’t useful in preventing super-spreading.

The piece is an important read and interesting throughout: just read the whole thing.

Naming names of shooters

posted by Jason Kottke   Oct 04, 2015

Josh Marshall argues provocatively and persuasively that news media, law enforcement, and everyone else should name the offenders in these mass shootings, in part because the refusal has become an empty sort of action that people can take to “help”.

It is a grand evasion because we need to make ourselves feel better by finding a way to think we are doing ‘something’ even though we’re unwilling to do anything that actually matters. Except for those immediately affected or those in the tightly defined communities affected we also shouldn’t give ourselves the solace of watching teary-eyed memorials or all the rest. Again, as a society we’ve made our decision. I would go so far as to say that it’s good for us to know Mercer’s name since we are in fact his accomplices. It’s good that we know each other.

Withholding knowledge is not the way forward.

Update: From the NY Times back in August, Zeynep Tufekci writes: The Virginia Shooter Wanted Fame. Let’s Not Give It to Him.

This doesn’t mean censoring the news or not reporting important events of obvious news value. It means not providing the killers with the infamy they seek. It means somber, instead of lurid and graphic, coverage, and a focus on victims. It means not putting the killer’s face on loop. It means minimizing or not using the killers’ names, as I have done here. It means not airing snuff films, or making them easily accessible on popular sites. It means holding back reporting of details such as the type of gun, ammunition, angle of attack and the protective gear the killer might have worn. Such detailed reporting can give the next killer a concrete road map.

(via @riondotnu)

Update: Read all the way to the bottom of this Mother Jones article for ways that they have changed how they report on mass shootings.

Report on the perpetrator forensically and with dispassionate language. Avoid terms like “lone wolf” and “school shooter,” which may carry cachet with young men aspiring to attack. Instead use “perpetrator,” “act of lone terrorism,” and “act of mass murder.”