Geneva, 14 February, 2021

There is a basic principle of pharmacology: that the only difference between a drug and a poison is the dose. What better example than botulinum toxin. This bacterial poison causes botulism by paralysing muscles and is said to be the most toxic of all toxins. In tiny injected doses it is… you’ve got it…. botox! Now, it was said that in his day, the roguish Saddam Hussein had hidden in his sand-pit of mass destruction 1,000 litres of botulinum toxin. This was enough, according to one report, to kill the whole human population assuming that the contents of this microbial hobble-bubble could somehow be distributed throughout the whole human population. 

Last week I took a stroll with a friend who is steeped in public health matters. We agreed that if we view the virus responsible for COVID-19 from its biological / evolutionary perspective, it is truly remarkable. This little tooled-up single strand of RNA, unlike botulinum toxin, has worked out its own distribution mechanism to poison the whole human population – and could still achieve this – by using…. da-da-daah… humans! Brilliant! That then got us thinking about what the total biomass of this virus might be. Would it fill a swimming pool? Or would it fill a beer glass? By surprising coincidence, I heard the following day that BBC science had set two scientists independantly the task of making precisely this calculation; one concluded a wine glass and the other a shot glass. Yes, were you to take all the viruses that are currently doing their pandemic round-the-world cruise, you could put them in a glass, swirl them around, sniff them and then take a sip. (Don’t try this at home.) This little tinker clearly out-does botulinum toxin on every front.

Staying with matters of the virus’s spread…. The Chinese authorities eventually permitted an international team from WHO access to Wuhan, the presumed site of origin of the COVID-19 coronavirus, on 14 January. Three weeks later the team is back in Geneva. Wow! That was quick! Their rather predictable, politically convenient but quite possibly correct conclusion is that the source of the virus was an unidentified animal or animals and that a leak from a laboratory is “extremely unlikely.” However, implying that laboratory leaks of important pathogenic organisms are “extremely rare” points a lack of historical perspective. Have Sverdlovsk, Janet Parker and the UK’s foot and mouth outbreak been forgotten? A good read on all this with its political implications was published yesterday by my full-of-common-sense friend Filippa Lentzos in the Bulletin of the Atomic Scientists. Filippa picks apart the WHO team’s report, points out that the WHO hierarchy may not agree with it and lays bare the political stakes.   

As if to muddy the waters, a study, published last week in the European Journal of Epidemiology, concluded that the virus responsible for COVID 19 might have been circulating in France early in November 2019. It cites the findings of an earlier report that the virus could have been circulating in Italy in September 2019. All this of course will bring a smile to the test tube of any Chinese virologist. Could it be, though, that the virus was already on the wing in autumn of 2019 and one variant was first identified in Wuhan? I can just see the WHO from our balcony here in Geneva. Perhaps I should brave the snow, cross town and knock on the institution’s front door with a “Oi! Whats going on ‘ere then?” But then I have to remind myself that when it comes to a subject such as this, the political tactics and media scoops play out over days whilst reliable science takes months if not years but will, in the end, arrive at something resembling the truth.

Otherwise the COVID-19 news is dominated by uncertainties relating variants and vaccines. To what extent do the different vaccines reduce transmission of the virus and its UK, South African and Brazilian variants? Will the different COVID-19 vaccines be as effective (in terms or reducing severe infections) against the variants? If not, will the second vaccine dose make a difference? Can different vaccinations be used for the first and second dose? In relation to these variants, does the protective effect of the different vaccines vary according to age of the person being vaccinated? If your country plans to issue “vaccination certificates,” will they be worthless-until-proven-otherwise with the arrival of a new variant? Our best scientists will answer these questions and more over the months to come, but the cold reality is dawning; we will be playing variant – vaccine catch-up for rest of 2021 and maybe for years to come. On this, I realise my opinion is no more welcome than a vocal vegan at a Trump rally. 

Geneva, 11 February, 2021

I caught Geneva Lux, the town’s light festival, just before its twenty-one installations were taken down. It was a cold, wet night and this was night-time viewing. There were few pedestrians about. A sign of the times was the number of food delivery bikes braving the rain-slick streets. Head down and struggling to keep my iPhone dry, enthusiasm was some way off but took a step closer when I found “L’Envol” in the Parc des Bastions.

Well done, Geneva, for rolling out public beautiful stuff in the era of COVID-19. On the outer wall of the Old Town, Chris Plant’s slow-colour-pulsating “Portal Harmonic” hypnotised a small crowd; me included.

My favourite lights had me enthralled and wandering around in small circles right outside Tiffany’s. “Hivernales Népenthèses” is Sophie Guyot’s take on a species of tropical insect-eating flower. I love the way these elegant boulder-based standing lamps have been orientated towards the luxurious premises of the famous jeweller.

The pandemic news gets no better. In the countries that have instigated distancing measures, the case numbers and mortality data are not falling as fast as expected. Even with the roll out of effective vaccines, the numbers will not suddenly drop to zero. The hard truth is that the shape of an epidemic curve dictates that the total number of cases will eventually be double of what we have recorded to date.

Different scientific institutions are getting a handle on the full implications of the different variants of the COVID-19 coronavirus and, importantly, how effective the different vaccines may be against these variants. This spontaneous generation of variants gives a new sense of urgency to vaccination campaigns. Political spats about availability of vaccines are unsurprising. Currently, the EU claims Astra Zeneca is not fulfilling it’s contract to supply its vaccine in sufficient quantity as European countries face a difficult and delayed roll-out. The WHO points out that vaccine availability must be fair and reach countries without developed public health infrastructure. This is not unreasonable; the people in these countries could act as sources of yet more variants that carry the potential to overcome a vaccine and spread to other countries. Meanwhile, Switzerland seems to be going about its vaccination programme calmly and efficiently. I have registered for my jab; it should be three to four weeks away.

It may be all too obvious, but the longer this pandemic runs, the more severe will be the long term impact. It is inevitable that COVID-19 related studies, reports and enquiries will occupy our news cycles and concerns for years to come. I would hope that the WHO has already foreseen a major and apolitical lessons learnt review that is orientated around preventing and managing future pandemics. Such a review would be incomplete without something conclusive about the origins of this virus, how the pandemic affected poor people disproportionately in most countries and how effective or ineffective different countries’ strategies proved to be. I predict a continued academic commentary about the interface of politics and the pandemic especially in the USA. With respect to the development, distribution and delivery of the vaccines, we will hear much more of governmental and corporate wins and losses. I make no predictions about the economic impact of the pandemic nor how it will be recorded other than it will be profound and long lasting. Another long running source of research will be the impact on the education and mental health of children who have missed so much school time and the accompanying social interactions. COVID-19 will have a long, long tail.

Closer to home…. I’m not really a great TV watcher but the pandemic has changed my habits. I never thought I would spend so much time watching Netflix. My impression is that you have to kiss a lot of frogs before one proves to be… well…. a prince. “Call My Agent” (prince) is a French production about actors and their agents finding themselves embroiled in all shades of gallic mischief. It is thoroughly entertaining. By contrast, Bridgerton (frog) is the TV streaming giant’s current smash; this is surprising. Lavish sets, exuberant costumes and a wondrously knee-taking cast make the first few episodes just watchable. However, we abandoned it as the story-line failed to get out of its lame first gear and whole episodes were dominated by the era’s lack of sex education for young ladies and scenes that could easily pass as raunchy Kleenex ads. Yeuch! (Sorry… s(p)oiler alert!)

Hoping my readers are well, safe and as happy as possible under the circs.

Geneva, 25 January, 2021

The two main sources of the current news agenda – the COVID-19 pandemic and the shockwaves emanating from Washington – exclude other world changing events from our attention. On 22 January, a United Nations treaty prohibiting the development, testing, production, stockpiling, stationing, transfer, use and threat of use of nuclear weapons entered into force.

Yes, nuclear weapons are now banned under international law. Obviously, the states who possess nuclear weapons and their closest allies have not (yet) signed up to this treaty but their diplo-kinder-doublespeak will now sound increasingly hollow. This new prohibition with 52 member states heightens the imperative of eventual elimination of nuclear arsenals: something that all nations have committed themselves to through being party to the Nuclear Weapons Non-Proliferation Treaty.

Most Brit ex-pats like me probably look to the same website for their international news. I couldn’t help noticing just how opportunistic even the BBC can be. This standard-bearer for global media reported two days ago that the UK variant of the COVID-19 coronavirus “may be more deadly.” What….? Oh No! We’re all gonna die!!! The scientists responsible for this “news” had reported that, up to now, of 1000 people over 60 years of age with COVID-19, ten would be expected to die. There were indications that this figure might rise to thirteen in cases caused by the UK variant. Yesterday, the scientists concerned wanted to cast a more realistic light on these “not particularly strong” findings and pointed out that the Prime Minister and the BBC had blown it out of proportion. The BBC then headlined with “Covid: ‘More deadly’ UK variant claim played down by scientists.”  Brilliant! Two front page news items about nothing newsworthy.

Staying with the BBC for just a bit… And I try not to put my political colours on show in these Chronicles, but…. Yesterday, another upfront but underwhelming news item reported that Boris Johnson had a telephone conversation with President Joe Biden. Wowzers! However, the informative tail-piece assures me that incisive journalism is not a thing of the past. It appears that Mr Biden once referred to Mr Johnson as a “physical and emotional clone of Mr Trump.” I have to say, this Biden chappie seems to made of the right stuff.

Eight weeks back, we welcomed the news that COVID-19 vaccines had been developed and approved for use. We believed that they would bring about a rapid end to this pandemic and that our lives could get back to “normal” in a matter of months and certainly by the end of 2021. It turns out that our optimism was short-sighted and short-lived. The situation evolves rapidly as the virus is proving to be a cunning and agile adversary. The emerging picture is one of a desperate race to vaccinate whole populations as case numbers, hospital admissions and deaths rise in many countries despite a variety of stringent social distancing measures. Whilst there are, apparently, hundreds of recognised variants of the virus, the three causing most concern because of their transmissibility are those thought to originate in the UK, South Africa and Brazil. 

There is currently no doubt about the safety and efficacy of the approved COVID-19 vaccines in terms of limiting severity of outcome of infection. However, the big unknown is the extent to which immunity prevents transmission. Even if a person is immune – either from vaccination or having had COVID-19 – he or she may still carry and transmit the virus. It is not, in infectious disease terms, a “sterile immunity.” This means that the glittering prize of “herd immunity” may not be achievable. The most likely long term scenario is that COVID-19 will become just another common and mild flu-like illness that seriously affects only those who have not been vaccinated. Vaccines may have to accommodate variants and so vaccination programmes may have to be repeated. The over-arching and achievable objective of our public health authorities is not to eliminate transmission but to reduce the severity of COVID-19 infections so limiting associated deaths and, at the same time, protecting our health services.

A title for a painting is important as it can change how a viewer might look at the piece and what he or she perceives. The above is a recent snowed-in lockdown painting. I cannot shake off my fascination for African masks and I remain gripped by the daily political developments in the US. So I’m struggling to find an appropriate title here. “The Blues”? “BlackLivesMatter”? “Intercontinental”? Does anyone have a suggestion? Perhaps I should simply dedicate it to the extraordinary young Amanda Gorman who read one of her extraordinary poems at Joe Biden’s Presidential inauguration last week.

I am sure that if I had the privilege of talking to Ms Gorman and started a sentence with “Well, in my day…”, she would be quick to point out that it was no longer my day. It was hers. And Greta Thunberg‘s. And my nephew’s. The nephew who, now in his twenties and fired up by global issues, asked me “Didn’t you guys know you were frying the planet? And you still eat beef! I mean, wasn’t it obvious that booming city populations and international air travel was an infectious disease catastrophe waiting to happen?” He was on a roll. “Didn’t you know that we are inheriting your debts together with a global financial system that’s a house of cards?” Exasperated, he finished with “Didn’t your generation think about the world you were passing on to us?” I couldn’t help thinking the youngster had a point. I replied “Well, in my day…… We didn’t have the internet. We weren’t so well informed. Our main global concern was nuclear weapons.”