Saturday, September 25, 2021

THE PLANET CANNOT BE SAVED WITHOUT GLOBAL REGIME CHANGE



All countries without exception are interlinked and interdependent in the global market place. This reality became starkly evident in the early days of this pandemic when more and more countries closed their borders, resulting in interruptions in supply chains that caused many factories to grind to a halt. Many countries had also outsourced the manufacture their own PPEs, and during border closures and lockdowns struggled to obtain enough PPEs to keep their populations and healthcare professionals safe. Indeed, most of what we consume is manufactured elsewhere, where the costs of production are considerably lower. Outsourcing production not only results in huge savings in labour costs; it also evades the much stricter environmental standards, workers rights, and workplace safety standards in place in much wealthier consumer nations. The raw materials and energy required for manufacture are also sourced from countries all over the world, from whichever country can supply the demand at the lowest cost. Almost every good we consume, from cell phones to clothes to automobiles to food, involves the coordinated actions of a complex global web of people from many countries around the world. Restrictions on the movement of goods and services are minimal, and efforts are being made to further reduce them through minimizing government intervention –through the promotion of what is called Free Trade. The remarkable thing is that for the most part it is self-regulating. For middle class and upper middle class this system has been working well, providing them with an ever increasing array of consumer goods at affordable prices. They most anxiously await the full recovery of this economic system in the wake of disruptions caused by the pandemic.


But can a self-regulating system, characterized by minimal government intervention, respond to that other even greater existential crisis –to global warming? Is it simply a matter of switching over to renewable energy so that economic growth can continue unabated without destroying the planet? Is national governments' “putting a price on pollution” and setting carbon emission reduction targets going to be enough? To date even significantly reducing carbon emissions within our borders has proved to be a challenge, especially for countries whose economies rely on the extraction and exportation of fossil fuels. Should countries and corporations be allowed to exempt themselves from lower emission requirements in exchange for buying up carbon syncs that presumably offset their emissions? (forests etc. known to sequester carbon) Externalizing production costs has become essential to compete in the global marketplace; only by outsourcing production to countries with grossly underpaid workers, often working in abysmal conditions, in countries with minimal or unenforced labour and environmental standards, can suppliers supply the insatiable appetites of consumers at competitive prices. The social and environmental costs will be borne by others in the countries that produce the goods we consume.


But due to the global nature of the climate crisis the cost of carbon emissions cannot be externalized. Reduction in global carbon emissions cannot be achieved without the cooperation of all the countries that supply the world's consumer goods. The refrain that “We are all in this together”, belied by the global distribution of vaccines, has to become much more than a euphemism if the worsening of the global climate apocalypse is to be avoided. Even countries that have managed to meet national carbon emissions targets within their borders are not doing their part if they continue to import consumer goods with a high carbon footprint. Emissions must be reduced everywhere in the chain of the production process, from the extraction and shipping of raw materials, to the processing of materials into metals, plastics, etc., to the fabrication and assembly of all components into the end products, and the shipping of all of the above. That's a lot of emissions that aren't accounted for in consumer prices, but nonetheless form part and parcel of emissions embodied in the goods we consume. To continue this pattern of consumption is to continue to participate in ecocide and self-annihilation, regardless of how many EVs we buy or solar panels we install. 

 

Can developing and newly industrialized countries be relied upon to voluntarily reduce their emissions in a way that not even most wealthy countries have thus far been willing to do? Can those stitching our clothes together, or working long hours in unsafe working conditions, earning a pittance insufficient to properly house or feed themselves, be expected set aside all immediate existential threats to themselves and their families and get on board with the climate agenda of a few rich nations? If they are not, will we encourage them by financing their transition to green energy? Or will we resort to some form of coercion? Without a pan-global government, who would do the coercing? The under-funded UN, in which five countries who almost never agree on anything have veto power, is not up to the task, much less the WHO, whose pleas for a more equitable distribution of vaccines continue to fall on deaf ears. If rich countries were to put tariffs on all goods imported from non-compliant countries, would that result in reduced emissions? Or would that only result in even more deplorable working conditions as suppliers try to keep up profits despite tariffs? What about an outright ban on such imports? But that would hurt compliant rich countries as well, because they would have to pay the full cost of production of consumer goods. All the externalized costs –the cheap labour, the lax or poor worker safety and environmental laws, etc. that made these imported goods so affordable--would then have to be added to the sales price. Citizens of rich nations would have to absorb, not only the costs of reducing their own emissions, but also the higher consumer prices required to pay for the transition to green energy in the countries producing these goods, resulting in inflation. Perhaps that is as it should be, since it is the citizens of rich nations that, because of their high levels of consumption, are primarily responsible for global warming. When we moved industry off shore we also moved their carbon emissions off shore, out of our national jurisdiction, but they still take place on the same planet. It is urgent that we take ownership of all emissions associated with the products we consume, including those being produced offshore.


To date even most relatively wealthy countries haven't done much to reduce emissions, despite the devastating impact of increasingly frequent extreme weather events. There are a number of reasons for this. Rich countries can deal with catastrophic weather events, and are becoming increasing adept at preventing economic, political and climate refugees from entering their countries. Ironically the high costs of dealing with emergency responses and the rebuilding required after a fire, flood, hurricane or other extreme weather event register as being of net-benefit to the country in the accounting. The billions of dollars in expenditures such events require all contribute to the GDP and therefore register as economic growth. A few good storms or fires or floods can boost economic growth, while climate action –shuttering all fossil fuel and related industries—detracts from economic growth. As long as the economy is in the driver's seat, in the short term governments are more likely to choose coping with climate change and extreme weather events over the slow almost imperceptible benefits of reduction of global warming in the longer term –a far longer term than the term in office of any elected government. Even when more and more of the general population is citing climate change as the number one issue facing us today, governments are slow to take action. Even political parties who include concern about carbon emissions in their election platforms are only addressing domestic emissions; they do not have a plan for getting poor and newly industrialized nations on board. They make no mention of the carbon emissions embodied in all the imported goods we consume. They do not acknowledge that the economy and perpetual economic growth can no longer remain in the drivers seat if we are to avert a complete climate apocalypse. Not nationally, not globally. Up until now we have left the allocation and use of resources to the algorithm of supply and demand, in which suppliers competed with each other to supply demand until equilibrium was reached. Now we need to suppress our inclination to compete and replace it with an inclination to cooperate. Unless a spirit of cooperation occupies the drivers seat we are doomed. That transition could prove to be an even more formidable obstacle to climate action than does the transition to renewable energy sources.  But we better get on with it, because time is running out, and without regime change we have no future.


Sunday, September 5, 2021

From COVID Prevention to Coexistance:




COVID vaccinations have become a very polarizing issue in Canada and elsewhere. The long-awaited vaccinations have arrived, but the promised salvation and return to normalcy remain elusive. The unvaccinated are increasingly being singled out as the primary obstacle to normalcy. To be sure, not all of the unvaccinated are unvaccinated because they are refusing vaccinations. Many –children under twelve and those with allergies to vaccine components for instance—would be refused vaccines even if they wanted one. But those who are eligible and nevertheless have not availed themselves of readily available vaccines are increasingly being disparaged and vilified as selfish greedy individualists whose non-compliance regarding vaccinations is prioritizing their freedom to choose over the common good. The vaccines are safe, approved by public health, and any side effects are negligible when compared to the risks of severe infection and possible death due to COVID infections. Severe infections requiring hospitalization, and scarce resources jeopardize not only those so infected, but all others they end up infecting, and many many others being denied access to increasingly scarce healthcare resources –a triple jeopardy. It all seems pretty black and white –the us who are fully-vaccinated and the them who are not. The incumbent Liberals, who have opportunistically called an election in the midst of this pandemic, are exploiting and exacerbating this great divide, betting that the fully vaccinated majority will join them in denigrating and vilifying the unvaccinated, and vote Liberal. A small number of very vocal and increasingly confrontational anti-vaxers are targeting politicians on the campaign trail and impeding access to hospitals by their actions. Despite being only a very small percentage of the so-called vaccine-hesitant, conveniently for the Liberals, they have become the face of, and representative of all those opting out of vaccinations.


In reality things are a bit more nuanced than that. Could it be that some of the claims being made about vaccines are not as black and white as the official narrative leads us to believe? Lets take a closer look at some of them:


  • The Vaccines are safe: In Canada expedited approval has been granted to AstraZeneca, Pfizer and Moderna vaccines under an Interim Order Respecting the Importation, Sale and Advertising of Drugs for Use in Relation to COVID-19 signed into effect by by the Minister of Health on Sept. 16, 2020. Expedited approval was deemed necessary because of the severity of COVID 19; going through normal channels for approval and waiting for more information about unforeseen long-term effects would have cost too many lives and overwhelmed the capacity of our healthcare systems. The efficacy of these vaccines at preventing serious illness and death in the short term has been deemed to outweigh any known and as yet unknown possible long-term adverse side effects. This interim order will expire on Sept. 16, 2021, but provisions to extend it are already underway:


As we reported, since the beginning of the COVID-19 pandemic, Health Canada established emergency pathways to expedite review and approval of drugs and medical devices for use in relation to COVID-19 through Interim Orders. Health Canada intends to leverage and build upon those emergency pathways, as well as other existing policies and procedures, in updating the regulatory framework for drugs and medical devices. (source: Canada: Health Canada's Proposed Amendments To The Food And Drug Regulations And The Medical Devices Regulations)



Most authorized vaccines in the US have been authorized for emergency use only (EUA). However, in August Pfizer was given full approval, despite the fact that it is far too early to know what, if any, the long term side-effects might be. Because these long-term side-effects remain unknown there are
no grounds for presuming there will be no serious delayed side-effects resulting from the use of the vaccine. Nor are there grounds to assume that there will be. It would be more accurate to say based on the scientific evidence to date the vaccines are presumed to be safe. While the known risks of side-effects caused by the vaccines are minimal in comparison with the severe illness and death that the virus often causes, the long-term risks associated with inoculations are unknown, and cannot be dismissed. The vaccine-hesitant may simply be less predisposed to ignore them than are pro-vaxers. The evidence suggests that, at least in the short term, vaccines are relatively safe compared to the risks associated with becoming infected.

The confidence of vaccine manufactures themselves is more in line with that of the vaccine-hesitant than with the pro-vaxers. Manufacturers are insisting on indemnity from prosecution for any unforeseen consequences resulting from the use of their products. Almost all countries have agreed to grant that indemnity, with a few exceptions; India, for instance, cannot procure and import vaccines because of it's refusal to grant manufacturers indemnity. Manufacturers are required to continue to conduct clinical studies on the long-term effects of their vaccines for five years or more.

  • The efficacy of vaccines: References to the efficacy of vaccines are often confusing. The efficacy of vaccines is actually a measurement of how likely a vaccinated person is to become so ill they require hospitalization, ICU care, and/or die as the result of a COVID infection. It is not a measurement their immunity, nor their likelihood of infecting others.

    While there is statistical evidence to suggest that fully-vaccinated people are less likely to become infected, and less likely to infect others, if they
    do become infected, how much less likely they are to become infected and infect others is much more difficult to ascertain. There are a number of variables at play here. Despite frequent references to “a pandemic of the unvaccinated”, we now know that “breakthrough infections” in which fully-vaccinated become infected do occur, and they can go on to infect others. How frequently such breakthrough infections occur is largely unknown.

    Because fully-vaccinated people are less likely to show symptoms they may not even know they are infected, and are therefore less likely to present for testing. Continued reliance on self-assessments as the primary indicator of infections –the daily monitoring of symptoms—will not detect asymptomatic infections, so the number of breakthrough infections may be much higher than the statistics on known infections imply. This statistical omission is further exacerbated because the fully-vaccinated are often exempt from the frequent random testing requirements imposed on the unvaccinated.

    Furthermore, statistical data on the efficacy of vaccines doesn't always distinguish between the original SARS-CoV-2 and its variants; the efficacy of a vaccine against the now-dominant highly contagious and more virulent Delta variant is markedly lower than the level of protection vaccines conferred on those exposed to the original SARS-CoV-2 virus. Data on breakthrough cases –infections of the fully-vaccinated—does not give us a very complete picture of the number of breakthrough infections in Canada. We know that with the Delta variant breakthrough cases are on the rise. Fully-vaccinated people are less likely to show symptoms, and are usually not screened unless they happen to live in an area with a high prevalence of the virus or are identified as being a close contact or were in a situation where a breakout has occurred. However, if they are infected with the now-dominant Delta virus, their viral load is likely to be equal to that of an unvaccinated person –they will be equally contagious. (See: What do we know about breakthrough COVID-19 cases? Experts break down the science)



Finally, the efficacy of vaccines is also known to wane over time. Although Canada is now a world leader in terms of the percentage of the population that has been fully-vaccinated, most of us have not been fully-vaccinated for all that long. Israel might be a far better bellwether in this regard, because it was the first to vaccinate the majority of its population, almost exclusively with Pfizer. Israel began vaccinating its population in December 2020, and many Israelis received their second dose soon after their first dose in early 2021. Perhaps
too soon after their first dose. While COVID news stories in Canada and much of the world talked about a “pandemic of the unvaccinated”, Israel talked of a pandemic of the double-dosed vaccinated. Either because the efficacy of vaccines is significantly less after six months—some studies suggest as low as 29 %; or because the second dose was administered too soon after the first; or because most were infected with the far more contagious far more virulent Delta variant; or most probably some combination of all three of these factors, many fully-vaccinated (two dose) Israelis ended up being hospitalized, some in ICUs:

What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. [As in Canada, the elderly were the first to be vaccinated. The elderly are not only among the most vulnerable; because they also received their vaccinations earlier their immunity has had more time to wear off.] (Source: A grim warning from Israel: Vaccination blunts, but does not defeat Delta)

  • Natural Immunity: Among the unvaccinated are those who have recovered from a COVID 19 infection and those who are generally healthy and simply assume they will recover if they do become infected. This assumption is probably fairly well-founded, since most healthy individuals do indeed recover while self-isolating at home and the vast majority of positive cases do not require hospitalization. In the early days of the pandemic people with mild symptoms were actually discouraged from presenting for testing to avoid further overwhelming already overwhelmed testing facilities. Fighting the infection conferred natural immunity on recovered individuals –an immunity that may well be superior to, and longer-lasting than the immunity conferred by vaccines. Some say the immunity of recovered COVID cases would not be bolstered by even one dose of a vaccine, and getting two doses is almost certainly pointless. Others say that their natural immunity may not extend to protection against new more virulent variants such as Delta, and recommend that recovered COVID cases also be fully-vaccinated.

    But, as we have seen above, even the fully-vaccinated may not be adequately protected from new and emerging variants. It is entirely possible that unvaccinated fully-recovered COVID cases have greater immunity than do the fully-vaccinated. The presence and number of antibodies can only be detected by a serology (blood) test. Serology tests are also the only way of determining if a recovered asymptomatic person was ever infected by COVID 19 in the first place. Certainly a person whose serology test indicates that he or she has had COVID and retains sufficient antibodies to fight off new infections should not be obliged to get vaccinated!

  • Long-haulers: Little is known about long-haulers, but we are learning more. Even the definition of a long-hauler is not widely agreed upon. Long-haulers are those who continue to, or begin to show symptoms long after most normal positive COVID cases have fully recovered. Their illness is sometimes referred to as a post-COVID malady, although some never even knew they had been infected until serology tests proved otherwise. These illnesses can be quite serious. Some children, who had initially remained symptom-free in the early days of their infections, were later hospitalized because of delayed adverse reactions to the infection.

  • Herd immunity: Herd immunity is no longer attainable. The numbers required to reach herd immunity have risen with the advent of new, much more contagious, and more virulent variants of the virus. It is no longer 70 % but 90 % of the population that must be immune to the virus to achieve herd immunity. Given that over 10 % of the population is comprised of children under twelve years of age who cannot be vaccinated, 90 % immunity is unachievable. If you add those who have allergies to that number, and all those experiencing breakthrough infections despite being fully vaccinated to that number, striving to achieve herd immunity is futile.

    This reality, though seldom stated, is reflected in the subtext of current COVID policies. The strategy is now to devise methods in which we can
    coexist with the virus. While vaccinations cannot end the spread of the virus and newly emerging variants, they can allow for the resumption of economic and leisure activity by the fully vaccinated. The incidence of severe illness and death is low enough among the fully vaccinated that they can be allowed to shop, travel, eat in restaurants, attend theatres, sports events and schools, and most importantly, work, without overwhelming the healthcare systems. But only if all eligible people become fully-vaccinated. Hence the incessant push to get everyone vaccinated. Those relatively few serious breakthrough infections, along with the serious infections among unvaccinated children and serious non-COVID illnesses, can all be accommodated by the healthcare system as long as there aren't large numbers of seriously ill unvaccinated COVID victims taking up most of the ICU beds.

These are but a few of the considerations to bear in mind when trying to make sense of the ever-changing COVID 19 protocols, vaccine passports, and vaccine hesitancy. Thinks aren't as black and white as they are made out to be. Some of the inconsistencies are due to trade-offs when public health policies are deemed to be too great an impediment to economic recovery. One has to parse out public health considerations from political considerations from economic considerations, all of which are often conflated by government recommendations and policies.


Public Health is administered by the provinces, and policies vary from province to province. A look at what COVID policies can do and cannot do provide clues as to whether they are primarily designed to prevent the spread of the virus, or allow for the resumption of full participation in the economy as producers, providers of services, and as consumers. We will take a cursory look at a few protocols and policies that remain in effect, that have been changed or relaxed, and new exemptions to certain requirements. This table does not capture all of the nuances, but the number of checks in the right-hand column, and particularly policies 1, 5, 6, and 8 which do absolutely nothing to prevent spread or transmission, are clearly designed to promote economic recovery in the midst of a pandemic rather than prevent or slow transmission. Note that the relaxing of student self-assessment symptoms not only allows more mildly symptomatic children to attend school; it also allows their parents to go to work while the child is in school.The granting of exemptions to the fully-vaccinated and the asymptomatic underscore that concern for the economy has now eclipsed concern about the spread of the virus. Vaccinations still play a crucial role, not because they will result in herd immunity and an end to the pandemic, but because the fully-vaccinated for the most part will be able to function normally even when they are infected. This will require periodic booster shots as the efficacy of vaccines wears off. The healthcare system can cope with a few cases of severe breakthrough infections, as well as non-COVID critical illnesses, as long as enough of the unvaccinated get vaccinated to ensure that the healthcare system is not once again overwhelmed by severe COVID cases.