Arranged Marriages

Arranged Marriages

“don’t ask if you’re being forced into marriage
by your family
or even by the man you’re marrying
ask if you’re forcing yourself.”

Xayaat Muhummed

Arranged marriages were the norm before the 20^th century. The higher the social stratum that a woman was born into, the more likely it was that she would have no say in choosing her mate. This custom reached its apex among royalty. Children of kings were taught early on that their future mate would be chosen strictly out of convenience and political necessity. Every once in a blue moon someone would break the mold. Queen Isabel I of Spain disregarded her half-brother’s (the king) command when she married Ferdinand, King of Aragón. This stormy but successful union produced several children: she forced all of them to marry people who would advance the interests of her kingdom. Along the way she stole her half-brother’s crown (after he died) and set the stage for Spain to become the most powerful nation the world had ever known. Maybe she knew what it took to get ahead.

I thought about this custom when I spoke to a friend, an Orthodox Jew, who told me that divorce was rare among people who shared his faith. I decided to give him a hard time.

Orthodox Jews probably do not marry anyone that they have met at happy hour.

I do not think that he took my jesting well.

This conversation reminded me of a medical ethics class that I took when I was in med school. During the lecture on marriage and divorce, our professor mentioned that arranged marriages resulted in very few divorces. He said that this made sense to him.

“Your parents love you. They will do nothing that would hurt you. We should require parental consent for all weddings.”

Of course, he was not serious. Yet his comment bore a lot of truth.

My computer crashed while we were in Spain. After I bought a new one, I began to download and organize my photos from the cloud. I ran into my parents’ wedding photo. I decided to write this blog.

This was a union destined to fail if there ever was such a thing. My father was 29. He was a small-town high school principal. My mother was 16, a junior at the school. Besides his administrative responsibilities, my dad coached the volleyball team (he knew nothing about volleyball, but once he led the team to the state championship game). He taught most of the math courses.

Much later, he told one of my sisters that my mom was the smartest student he ever had. Maybe because he had an unreasonable reverence for smart people, he approached her one day after class. He handed her a note.

“I am in love with you. I will come to your house tonight to ask your father for your hand in marriage.”

As you can tell, he was not a man fond of courtship and romance. There were many times that I wondered if he thought of life as if it were an algebra equation. You find the right algorithm; you follow the known rules to move the unknowns about; the answer will ensue.

My mother was terrified. Not of my dad: of what her mom would say. He was a handsome man. My mother, along with most of her female classmates, would find an excuse to walk past whatever classroom he was teaching in. The young women took a quick peek into the room, then continued their way down the hall, giggling to themselves. That was the extent of her “leading him on.”

Once she got home, she handed the note to my grandmother.

“I do not know why the professor gave me this.”

My grandmother read the note, dropped it, and smacked my mother in the face.

“The professor would not have given you this note if you had not led him to believe that you liked him. If you want nothing to do with him, when he comes over tonight you go to the door and tell him to go away.”

Today this interchange seems terribly wrong on so many levels… But this was 1941. War was imminent. The US had not yet fully emerged from the Great Depression. People in Puerto Rico had it even worse than Americans did. Women were blamed for any inappropriate remark or gesture a man made. My grandparents did not have much formal education. In that context, what happened made sense to all people involved.

My mother answered the door that evening. She asked my father to come in. She introduced him to my grandparents.

At that point, my grandfather asked my dad to go in his bedroom. Although he only had a third-grade education, he was a brilliant man who was intent on defending his honor. My father had broken at least two engagements in the past. I was told (by him) that his intentions were always honorable, but that his mother had refused to accept any Puerto Rican woman as his mate. At some point more than two hundred years ago the Garrigas had acquired a title of nobility and a coat of arms. My paternal grandmother wanted her son to marry aristocracy, not some girl from a small town.

Breaking an engagement was no small matter. Many people felt that the woman was always to blame for the breakup. It would be difficult for these “girls” to run into any man that would consider them marriageable.

Once he got my dad into the bedroom, my grandfather closed the door and took out a pistol that he kept at his bedside. He pointed it at my father’s head.

“You have broken several engagements in the past. What are your intentions with my daughter?”

My father assured him that he had nothing but honorable intentions. I have always wondered if he would have shown up at the church were it not for the gun that he remembered had been pointed at his head.

For the next three months my father came to my mother’s home to visit her, every evening, always within earshot of her family. They married on November 19, a Puerto Rican holiday. They thought that this would keep all snoopers out of church: people had a lot of work to do on holidays.

Many years later I went to the university library to check out a book. The middle-aged lady at the counter saw my ID and asked me:

“Garriga… Are you from Utuado?”

My mother was. I was born there.

She smiled.

“Many years ago, my family was driving through the island on a holiday (“the island” for Puerto Ricans is any place away from the coasts). When we got to Utuado there was a huge traffic jam. No car was moving. We had to park our car. We stopped the first person we saw. We asked her what the commotion was all about. She told us that Professor Garriga was supposed to get married, and people wanted to see if he would show up.”

I knew about my father’s broken engagements, and that the wedding ceremony had been well attended. I smiled, thanked her, took my book, and walked away.

What I found out much later was that my paternal grandmother (my grandfather died when my father was 7) had refused to go to the wedding. She told me during one of my many sleepover visits to her home. She lived in a town where several pretty young women resided. I found every possible excuse to visit her for a weekend.

My grandmother was very fond of me. Part of my payment for my lodging for those visits was to sit with her in the balcony of her home for a morning. She sat on her rocking chair and stopped all passers-by to chat, or admonish them for being too loud, or too lazy to go to work, or too scandalously dressed. During one of those conversations, she let it slip out.

“This is Paco’s son. He is an honor student. He is never in trouble. And to think that I did not approve of his mother! I did not go to that wedding! Now she is the best wife a man could ever have.”

Once I got back home, I did not waste a second to confront my father.

You never told me that grandma did not come to your wedding.

“And I did not care either!”

Said with anger and resentment. It was obvious to me that he did care. But there was the small matter of that gun pointed at his head…

My dad died in 1999, 57 ½ years after that fateful wedding. I have four siblings: all sisters. All of us finished advanced degrees. None of our children, or our grandchildren, has failed to finish college. My mother finished her PhD and became a college professor. She graduated college with high honors and three kids in tow.

I remember one Sunday that we were walking home from lunch at a local restaurant (we did not own a car. The first vehicle in the family was bought by my oldest sister when she got her first job). The dean of one of the university faculties was driving by when he spotted us. As Puerto Ricans often do, he stopped his car on the street, blocking traffic. He lowered the passenger window on the car and spoke to us.

“There goes the Holy Family.”

He waved to us and he drove away.

My parents, against all odds, made an untenable situation work. The child bride worked long hours and never seemed to be in a hurry. The universally admired professor eventually treated her as a full partner, although the first few years were hard for her. Their numerous nieces, nephews, students, and neighbors never had anything but respect and admiration for them. Even now, eighty years later, I hear from people who tell me what a positive difference one of them made in their lives.

It was not an arranged marriage, but maybe it had some element of parental consent.

My mother told me that once my father emerged out of my grandfather’s bedroom, my grandpa took her aside.

“The professor told me that he is serious about marrying you. We have always wanted a man of his intelligence and integrity for you. I think that you should say yes to him.”

That was the beginning of our family.

Covid Update XIV

General Course of the Pandemic

The daily number of new cases, both in the US and worldwide, is twice what it was in April. Vietnam, the exemplary country, has posted its first three deaths, while it tries to manage an outbreak in Da Nang (a foremost tourist destination). Almost every country in Southeast Asia is going through this “second wave” anxiety. Australia is closing Melbourne down. Spain has seen daily increases in its numbers. Italy has been given a respite, so far.

Almost every country in the world has seen a decline in the rate at which infected people are hospitalized, get admitted to ICU, or die. There are many potential explanations: all of them probably valid. Younger (healthier) people are getting infected. Doctors have learned a lot about how to deal with and prevent complications. Remdesivir and dexamethasone have helped. There is more convalescent plasma available. Maybe the virus has mutated into something less deadly (don’t tell that to Herman Cain).

Inexplicably, mask-wearing continues to be a source of controversy, not only in the US. Even worse, it has been universally appropriated as a battle emblem by right-wing, totalitarian heads of state. I figured it may be a good idea to identify masks as fashion accessories. Cool things to have.

Testing

We may be finally accepting pool testing as an adequate solution for the delays that we currently experience in getting results back.

The UK just bought millions of test kits that check for influenza and Covid-19 in the same specimen. They have promised that results will take 90 minutes, and they expect excellent accuracy. They plan to deploy these in facilities that care for the elderly.

There is a growing chorus that wants to accelerate the deployment of home kits that only need saliva to obtain an accurate result. I may have more solid information on this next week.

Treatment and Vaccines

There is nothing new on this front. As I have warned in the past, we are beginning to see people taking sides on which group of citizens will get to receive the vaccine when and if a successful candidate is approved. This “noise” will only get louder as we come closer to the rollout.

I want to use the rest of this space to rant against my fellow citizens of all stripes. To your eternal shame, you have used an unprecedented tragedy to try to make your political opponent look bad. Yes, all of you. One news station says that our death rate is the worst among wealthy countries. This is not true. The other side says that we have the best results in hospitalized patients. Also false. One side claims the current administration is disastrously incompetent. If this were the case, we would not have ramped up three years’ worth of vaccine work into three months. The other claims that we are the world leaders in innovation: not true; there are many contributors. It goes on and on.

Few politicians seem to be interested in working together to come up with a coherent effort at the state, city, and neighborhood level. I understand that the current national leadership has been absent from most of these efforts, but looking at how irrational people can be when all of them are grouped into a large cohort, maybe it was a good idea to try to handle this county by county. Now it is too late: we will have to take our lumps and see if we can make it to the other side with the least damage possible.

Let us talk about what “the other side” will look like, and when we can expect to reach it. Barring divine intervention or egregious political corruption, approval of a successful vaccine will not take place before November. Most likely it will be January before high-risk individuals are given their first dose. Most vaccines under investigation will require a second dose a month after the first one. It will take four to six weeks after that for patients to generate enough of an immune response. This gets us into late March, and only for the small percentage of the population that is at high risk. To vaccinate everyone will not happen before June 2021.

That is the best-case scenario. If the new vaccines only provide 50% protection, or if a serious side effect is identified after 200,000 people have been immunized, we can be in the same situation that we are in now twelve months from now. Unless someone comes up with an inexpensive, oral, effective treatment regimen. Do not hold your breath waiting for that to happen.

This should not be hard to understand. You, that means you, cannot continue to expose yourself to potential contagion because you are sure that our smart doctors will come up with an answer. That this plague will go away; that it has to, must go away. Not so.

The next issue is our schools; high schools; colleges. I wish that everyone will just stop screaming about this and take a deep breath. Read what I wrote above. We cannot keep children and adolescents out of school for another year. People who advocate closing the schools now are somehow delusional that this will be only a temporary state of affairs. All of the evidence points out otherwise. A large percentage (I think 30% is large) of our citizens will refuse to wear a mask and ignore suggestions to be judicious. We cannot even get millionaire baseball players who are under close supervision to grow common sense. It is unrealistic to assume that contagion will soon decrease enough to make it safer to open schools.

What to do? We need to treat this as the true emergency that it is. Hundreds of billions of dollars need to be spent on new ventilation systems, bigger classrooms, in-school nursing help, small dispensaries within easy reach, etc. We need to come up, now, with a rapid test that uses saliva or a mouth swab. Something that can be done daily. We have to give our teachers and other school employees “combat pay,” like we give our fighter pilots. We must have an agreement on how to make sure that no one is worried about liability in case a teacher or student gets sick. We must keep schools open twelve hours a day, twelve months a year, until our students catch up.

This is a huge undertaking. The alternative is much easier: we keep screaming at each other, we keep blaming the opposing party for anything that goes wrong, and we, all of us, get sucked into the whirlpool as we get flushed down the drain. Do not think that your job, your home, your investments, and your currency are safe. Do not, for a minute, assume that this is somebody else’s problem to solve. This is about you, it is happening now, and you better get to work on it.

Have I made myself clear?

Covid Update XIII

General Course of the Pandemic

Cases in the “hotspots” of Arizona, Texas, and Florida are leveling off, although at a high level. California is still on an upward slope. Many other states have increasing caseloads; they do not show up in bright red because they have smaller populations. For a more “granular” report go to the latest map and case count from the New York Times.

On the international front:

Some countries that had the outbreak under control have noticed upswings in the number of cases. Spain is concerned enough to have reinstituted restrictions throughout, mot prominent in Catalonia. Vietnam, the world leader in control of the virus, had one case appear in Da Nang: a city heavy on tourism. If you were there on vacation yesterday, you just earned two extra weeks of stay, whether you planned it this way or not. Hong Kong; Australia; South Korea have the same story. Africa and the rest of the Americas are doing poorly. S

School reopenings:

We have, again, managed to turn a conversation on how to best serve our children into political chaos and disarray. This one hurts me to the bone, because if there is anything that all of us agree on is that we want our kids to learn and grow up healthy. The CDC has modified its guidelines for safe operation of schools.

Unemployment benefits expired three days ago. The ban on evictions, and the temporary suspension of penalties for being late on student loans, expire in a few days. In Missouri, the ban on evictions never existed. We are soon to see thousands of people thrown out on the street. The bipartisan law that gave everyone an extra $600 a week did a lot to keep people fed and warm; it also lowered the number of people who qualified as being in a state of poverty. Republicans want that extra $600 to be lowered to $200, because there were (many) people who were making more money on unemployment than they were while working. This is true. It is also true that all of these people were very low-income earners; the ones that use extra money to spend it, not save it. These are the same people who will remain unemployed if restaurants and hotels continue to operate at little or no capacity. No chance that these people will refuse to go to work: their place of employment cannot hire them. It is also true that nobody can live on unemployment (about half your “normal” pay) plus $200 a week.

Many people made fun of our president for suggesting that UV light be used to treat people afflicted with the virus. There is an interesting TED talk about using UVC light to sterilize indoor spaces, thus making it less likely that there will be transmission in places like bars and restaurants. The UVC light does not penetrate human skin or eyes, so it is deemed safe. This is not, I repeat, not a treatment. Just a theoretical preventive.

Testing

There are many ideas on how to increase the efficiency and number of tests performed. This week there is nothing new on using multiple specimens to run one test, or on testing sewage. I found these suggestions on how to ramp up what we have interesting.

Treatment

The British company Synairgen reported last week that their inhaled interferon therapy markedly reduced the shortness of breath provoked by the virus, while decreasing mortality and length of hospital stay.

Vaccines

The three main (Western) candidates will go into large-scale (Phase III) testing now. As I have said in the past, several large problems have to be dealt with. While Phase II studies recruit a few young and healthy people, Phase III studies must enroll a larger sample (about 30,000 volunteers) that represent the population as a whole. That means that the study directors must find thousands of people with chronic diseases (like diabetes and hypertension) to agree to participate AND remain available for follow-up for months and even years. It may well turn out that those who agree to participate consider themselves healthier than the average diabetes or asthma patient. If that happens, we will not get a good idea if the vaccine works for the sicker people. Underserved populations, that have a well-deserved mistrust of medical researchers, have to be convinced that this time they will not be taken advantage of. It is likely that the three vaccines tested will have different degrees of “success.” We will, for sure, be subjected to claims from all three that they are the best, and that the only reason that Vaccine A showed better numbers is that they recruited fewer old people, or failed to record deaths properly, and so forth. The studies are more likely to come up with a valid conclusion when they are conducted in areas where there is a lot of ongoing contagion. If, through some coincidence, the number of infections in a population sharply decreases once the study starts, it may take years to come up with a sign that the vaccine works (or not).

I saw a YouTube profile on Sarah Gilbert, the lead researcher for the Oxford group. I found it almost as engaging as watching a movie about a medical hero. Her lab was close to having no money to continue to operate. Now they stand to be the first vaccine to finish their trials. To give hope to billions of human beings. Hope that you enjoy it.

I hope that you like the new format to the updates. The reason for the change is to try to reach a wider audience. I very much want to read your comments and suggestions. If you want to do me a huge favor, forward this content to everyone that you are linked to. I promise that I will remain objective, and that I will continue to scour everything that comes out in order to give you a readable summary.

Be kind. Wear a mask. Say “thank you” a lot.

Marital Baseball

“You can observe a lot by watchin’.”

Yogi Berra

I was going through a tough time. In retrospect, it sounds like an insensitive thing to say. There are people who have no job and nowhere to stay for the night, and I was a physician who had a busy practice and good health to spare. Yet… I was going through an acrimonious divorce. I had three daughters who were understandably resentful that their lives had been turned upside down. I found out how expensive it was to pay for two homes; two phone bills; two and sometimes three of everything.

Most of all, I considered myself a failure. The privileged child who had found school and medicine so easy to grasp had to face the fact that personal talent does not assure success in life. How had I gotten myself in this situation?

The best life advice, at any time, is to get over today the best way you can. I understood this on a conscious level, but I kept thinking about my future. How do I make sure that this does not happen again? Is there something wrong with me? Will I ever be happy with a mate?

There should be a law that severely punishes anyone who starts dating soon after (or before) a divorce is final. It is highly advisable to be alone for a few months. Take care of yourself; do your own cooking; pay your own bills; understand that the world does not end if you lack intimacy for more than a week. Our society is not set up this way. Most people venture out into dating quickly, as if to convince themselves that the sooner that they can rectify past poor choices, the more successful they will be. As if time were a-wasting. Being a man who hates to ask for or follow directions, I started to see a few women.

Good people; all of them. There was nothing “wrong”” with any of them. It’s just that I kept getting this feeling that we were auditioning for each other. That they were not getting to see, or understand, who I was. And vice versa. With one exception. My nurse and office manager acted like herself, probably because we had known each other for years, and it would have looked deceitful had we tried to become an alternative soul after 6PM.

It is a horrible idea to date people that you work with. In Spanish there is a saying about not pooping on the same table that you eat. It is an even greater infraction to become intimate with someone who responds to you at work. So that is exactly what I did. There was a large part of me that told me that this was not an even playing field for her. Yet I persisted. Of course, I had doubts, but things were going so well that I tried to ignore them.  I felt very relaxed in her presence.

Several months passed, and I was still uncertain. Something had to be wrong; there had to be a hidden character trait that would prove to be poisonous. I just had not seen it yet. Baseball season came around, and I asked her to go to a game with me.

For those who do not know me: I am Puerto Rican. 99% of Puerto Rican babies learn how to say “ball” and “hit” long before they say “mama.” The few who start out by blabbering “papa” are immediately referred to a pediatrician before it is too late to correct their behavior. To make matters worse, I live in Saint Louis, a city whose inhabitants believe that Stan Musial had divine powers. My first wife could not tell a bunt from a sac fly. I understood that this was not the reason that we could not get along, but who knows?

She wore jeans, and sneakers, and a Cardinals cap. Check. She sat in her seat and immediately put her feet up on the chair in front of her. Check. She ordered a beer, and then another one. Check. It was a well-pitched game. When a Cardinals player stroked the first hit of the game, she let out a loud “Yeah!” at the same time that she stood up and clapped her hands. Check. Then came the whistle: loud; shrill; the kind that can pierce your eardrums. I have never been able to learn how to whistle. In an instant I knew that this was THE turning point.

“Will you marry me?”

There have been thousands of games since then. Even when we are behind by seven runs in the bottom of the ninth, she is there with me. Together with the sneakers, the beer, and the whistles. A few years ago, I got her one of those expensive Cardinals shirts (Yadi’s, of course) for her birthday. It was received with more emotion than if I had given her a diamond ring. When a player from Triple A is promoted to The Show, she knows that this guy was not there yesterday.

“Who is this guy?”
Our new outfielder.
“Is he from the Minors?”
Yes, he was tearing it up in Memphis.
“He’s cute.”
I do not think that this is why he got called up.
“I like his butt. He has a nice butt. Reminds me of Tommy Herr.”
You say that about all of them.
“I do not know why it is. Baseball players are cute and have nice butts. I wonder why.”
If he cannot hit a slider his butt will not help him. Let us hope that he can adapt.
“He’s still cute.”

Yesterday our long-delayed season got under way. Peace and wafts of magic are in the air. We have hope. For three hours there is nothing wrong with the world. Almost forty years later, we sit in front of the TV and we feel that time has not touched us. That the choice that we made that long ago was, without a doubt, the best thing that ever happened to us.

COVID Update XII

_{Walking over the clouds in Teide Mountain, Canary Islands}

General Course of the Pandemic

Cases in the United States have reached the 70,000-daily plateau. Although the bulk of the new cases reside in Arizona, California, Texas, and Florida, this apparent skewing is likely due to the fact that these are the most populous and urbanized states outside New England. Most experts agree that it is only a matter of time before the rural areas become enmeshed in the sticky web that this has become. I already see sporadic stories from relatively isolated areas in Kansas and other “rural” states detailing the misery that is generated when half of the people that you know are in danger.

Many states have agreed to pass mandatory mask ordinances. A few remain resistant. The reason these governors give for refusing to concede the obvious is twofold: “The people” will know what is best for them, and “The people” want to keep their freedom to choose. So far, they have not rescinded the mandatory use of seat belts, or the requirement that every vehicle stop at a red light. But you never know; they may surprise us.

Last week we discussed that it was only a matter of time before the death count rose. Right on schedule, we have seen a sharp rise in the number of casualties. Again, please remember that it is not only the dead that we should mourn. There are tens of thousands of individuals that have survived, only to enter an alternative universe where it is hard for them to comb their hair every morning. How, as a nation, we intend to nurse these people back to health remains a problem that is barely mentioned by federal authorities. It took two years, on the average (before Covid-19), for social security to adjudicate disability claims. Can these people remain without a salary, or health insurance, for that long? I have read nothing; I mean nothing, on what the plans to deal with this issue are.

Scientific data that shows the value of wearing a mask accumulates. Two Missouri hair stylists that unknowingly exposed 143 customers to their virus wore masks while at work, as did most of their customers. There was no contagion reported. Another study that used a mannequin’s head powered by an atomizer showed that even a handkerchief placed over the mannequin’s “mouth” proved effective at limiting the distance that particles traveled when expelled. Of course, a cloth mask with a good fit worked even better.

Small outbreaks in China, Australia, Spain (Catalonia), and South Korea have precipitated prompt response from their authorities. Vietnam is still, by far, the world leader in safely handling the outbreak. Africa and every country south of Texas is suffering.

Testing

My wife got tested last week because she had fever, muscle aches, and gastrointestinal issues. It took five days for her results to come back. These delays are the rule for the past month. Which means that, from a preventive standpoint, getting tested is useless. A few weeks ago, Dr. Fauci mentioned that the government was looking at grouping tests: running ten samples on one test, as they do in China. Just yesterday I read that maybe they would start doing this with four specimens at a time. This approach will only work in areas where the virus is not very prevalent yet. It is beyond my understanding why we have not pursued antigen testing with more vigor. Although antigen tests are only about 80% accurate, they cost less than five dollars each (as opposed to $100 for a PCR), and results are available within minutes. We could afford to open schools and test children daily because they use saliva or a cheek swab. Also, no reason as to why they have not pursued testing sewage, which is cheap and screens hundreds of people at a time.

I listened to a TED talk today that mentioned Ginkgo Bioworks. A fascinating story of bioengineering. They are going all-in on Covid-19 testing; the CEO thinks that within 2-3 weeks they will be able to run 500,000 tests a day using their PCR technology. They have recently received more than a billion dollars in venture capital funding. No mention of what they intend to charge for their tests.

Treatment

The major story here is that there is not enough remdesivir to go around, even for the wealthy countries. Forget about Africa and the Middle East. As I mentioned before, the Regeneron monoclonal antibody results are due to be published soon. The promise that there could be a safe and effective oral treatment was probably not founded on reality. No recent upgrades on the llama nanoantibodies.

Vaccines

The study on the Oxford/ Astra Zeneca vaccine was published today on The Lancet. This study was done in Wuhan. The vaccine starts with an adenovirus, which is a common virus that causes respiratory symptoms. The viral DNA is manipulated so that, when it enters a human cell, it is forbidden from making copies of itself. They have found a way to take the Covid-19 virus and strip it of part of its RNA; the one that codes for the “spike” protein. They take this RNA and piggyback it onto the adenovirus DNA. Then they inject the mix into some very trusting people who feel well.

This approach was tried on Ebola. I am not sure how it worked. My understanding (I could be wrong; have had no time to check on this) is that no vaccine that uses this technology has ever been licensed. In any case, all people who were so inoculated developed good antibodies against Covid-19. We do not know if this will translate into preventing or decreasing the severity of the infection. Two encouraging signs: there was also a good T cell response (Helper T cells help, as their name implies, to augment immune responses), and seven out of eight ferrets treated with this vaccine avoided infection even when the virus was flushed up their noses.

The Chinese Army vaccine also published their results today. Not as good an antibody response, and a higher frequency of side effects, but no worry: they will start immunizing their troops in August. There are advantages to a totalitarian regime, if only they incur to the scientists and higher-ups. As far as the unfortunate Chinese Army conscripts… Hey, they have a job, right?

I cannot overemphasize how cautious we need to be about this vaccine issue. There has been so much money (and effort) poured into this quest, that people in the middle of this project may ignore warning signals because they so desperately want (need?) this to work. If the majority of the population decides that they will not agree to getting the vaccine, it will not work no matter how safe and effective it is (see recent measles cases in the US). If politicians decide that launching a not fully tested vaccine is going to help them in the elections, we may be told false information about it, and launch it they will, most likely shortly before the elections, too much fanfare.

Stay tuned. Wear masks. Be generous.