When will it ever end? When will it ever end?

When will COVID‐19 ever end? Various countries employ different strategies to address this; time will tell what the best response was. Subject Categories: S&S: Economics & Business, Microbiology, Virology & Host Pathogen Interaction, S&S: Ethics

Peter Seeger’s anti‐war song with its poignant refrain, stretching out the second “ever” to convey hopeless fatigue with the continuing loss of life, applies to the pandemic too. “Where have all the old folks gone?” may replace the loss of young men in Seeger’s song. But they keep going, and it is not happening on distant continents; it is happening with them distanced in places they called home. At the time of writing in early March, there are a few answers to Seeger’s question from around the world. There are the isolationists who say that maintaining a tight cordon around a COVID‐free zone is the way to get out of the pandemic. There are the optimists with undiluted faith in the vaccines who say it will be all over when everyone will get a jab. And there are the fatalists who say it will eventually end when herd immunity stops the pandemic after many people have died or fallen ill.Living in Australia where there are only sporadic cases of COVID, it is tempting to see the merits of the isolationist strategy. Only a small number of international travelers can enter the continent every week. Coming back from Europe in November, arrival at Brisbane airport was followed by police‐cordoned transfer to a pre‐allocated hotel—no choice, no balcony, no open windows—where we stayed (and paid) for a 14‐day confinement. On release, it was strange to find that life was close to normal: no masks and nearly no restrictions for public and private meetings. Sporting events and concerts do not have attendance restrictions. All that was different were easy‐to‐follow rules about social distancing in shops or on the streets, limited numbers of people on lifts, and a requirement to register when going to a restaurant or bar.Since I settled back to COVID‐free life in Australia, the last incident in Queensland occurred a month ago when a cleaner at a quarantined hotel got infected. It was “treated” with an instant 3‐day “circuit‐breaker” lockdown for the whole community. Forensic contact tracing was easy, and large numbers of people lined up for testing. Seven days later, the outbreak was declared over. A police inquiry examined the case to see whether regulations needed to be changed. The same rapid and uncompromising lockdown protocols have been employed in Melbourne, Perth, or New Zealand whenever somebody in the community tested positive. There is also continuous monitoring of public wastewater for viral RNA to quickly identify any new outbreak. Small numbers of positive cases are treated with maximum restrictions until life can return to “normal”. The plan is to expand these state policies to achieve a COVID‐free in Australia along with New Zealand and eventually the Pacific Islands.The strict isolationist policy has its downsides. Only Australian citizens or permanent residents are allowed to enter the country. Families have been separated for months. Sudden closing of borders makes the country play some musical chair game: When the whistle is blown, you stay where you are. Freedoms that have been considered as human rights have been side‐stepped. Government control is overt. Nonetheless, the dominant mood is that the good of the community trumps that the individual rights, which may come as a surprise in a liberal democratic society. People benefit from the quality of (local) life, and while there is an economic hiatus for tourism and international student business, the overall economy will come out without too much damage. Interestingly, the most draconian State leaders get the highest rating in the polls and elections. Clear, unwavering leadership is appreciated.Given their geographical situation, Australia, New Zealand, and other islands have clear advantages in pursuing their successful isolationist policies. For most of the rest of the world though, the answer to “when will it ever end” points resolutely and confidently to vaccines. With amazing speed and fantastic efforts, scientists in university and industry laboratories all over the world developed these silver bullets, the Krypton that will put the virus in its place. Most countries have now placed all their chips on the vaccine square of the roulette table.However, there are some aspects to consider before COVID will raise the white flag. It will take months to achieve herd immunity; a long time during which deaths, illness, and restrictions will continue. With different vaccines in production and use, it is likely that some will protect better against the virus than others. The duration of their protection is still unclear, and hence, the vaccine roll‐out could be interminable. More SARS‐CoV‐2 variants are on the rise challenging the long‐term efficacy of the vaccine(s). The logistics and production demands are significant and will become even more acute as the vaccines go to developing countries. Anti‐vaxxers already see this as an opportunity to spread their mixture of lies, exaggerations, and selective information, which may make it more difficult to inoculate sufficient numbers in some communities. And yet, for most countries, there is no real alternative to breaking the vicious cycle of persistent local infections that are slowed by restrictions only to explode again when Christmas or business or the public mood demands a break. The optimists are realists in this scenario.The third cohort are the fatalists. The Spanish flu ended after two years, and 50 million deaths and COVID will also run out of susceptible targets in due course. But herd immunity is a crude concept when the herd is people: our families, friends, and neighbors. Fatalism could translate into doing nothing and let people die and that is not a great policy when facing disaster.The alternative of doing nothing is to combine various strategies as Israel and the UK are doing: to adopt some of the isolationist approaches while vaccinating as many people as quickly as possible. The epidemiological data indeed show that restrictions on interactions do reduce the number of cases. Some countries, Ireland for example, have seen ten‐fold reductions in daily cases even before the first needle hit an arm following tightening of social interactions. This shows that the real impact of the vaccination will only be known when a sufficient percentage of the population has been immunized and the social restrictions are lifted. Australia with its significant travel restrictions is another successful example. In addition, contact tracing and testing are very helpful to contain outbreaks and create corona‐free zones that can be expanded in a controlled manner. Of course, there are local, political, and economic factors at play, but these should not block attempts to lower infection rates until sufficient numbers of vaccine doses become available.So, the answer to the question “when will it ever end?” will require a combination of the isolationists and the optimists such that the fatalist solution does not prevail. It will be interesting to revisit this question in two years’ time to see what the correct answer turns out to be.     

When may green plants be aposematic?

During the long, dry summers, the deserts of the Middle East are almost devoid of green plants. In the summer, most annuals, geophytes and hemicryptophytes either are dormant in the soil or have already been eaten by the grazing flocks. Many shrubs are summer deciduous or enter summer dormancy with minimal green canopy. However, there are several common plants that, contrary to the general phenology, are conspicuously green during summer, when all the surroundings are yellow. In such conditions, green is conspicuous and contrasts with the background, as do yellow, red and black in 'greener' ecosystems. The summer-green plants are also characterized by being poisonous or thorny as protection against herbivory. During winter and spring, when there are plenty of other green, more palatable annual plants, herbivory pressure is much lower and they need less protection. We propose that during summer in the dry desert, when most other plants are dry or indistinctive, a vivid green colour can be aposematic.  © 2004 The Linnean Society of London, Biological Journal of the Linnean Society , 2004, 81 , 413–416.     

Evasive mimicry: when (if ever) could mimicry based on difficulty of capture evolve?

We elucidate the conditions under which an easy-to-catch edible prey species may evolve to resemble another edible species that is much more difficult to capture ('evasive Batesian mimicry'), and the conditions under which two or more edible but hard-to-catch species evolve a common resemblance ('evasive Mullerian mimicry'). Using two complementary mathematical models, we argue that both phenomena are logically possible but that several factors will limit the prevalence of these forms of mimicry in nature. Evasive Batesian mimicry is most likely to arise when it is costly in time or energy for the predator species to pursue evasive prey, when mimics are encountered less frequently than evasive models and where there are abundant alternative prey. Evasive Mullerian mimicry, by contrast, is most likely to arise when evasive prey species differ in abundance, predators are slow to learn to avoid evasive prey and evading capture is costly to the prey. Unequivocal evidence for evasive Batesian or Mullerian mimicry has not yet been demonstrated in the field, and we argue that more empirical work is needed to test whether putative examples are indeed a result of selection to signal difficulty of capture.     

Can doctors place limits on their medical practices?

PHYSICIANS SHOULD EXERCISE GREAT CAUTION and probably seek legal counsel if they decide to place specific limits on the work they will do or patients they will see, lawyer Karen Capen warns. The BC Human Rights Council recently ruled that a physician had violated the province''s Human Rights Act when he declined to provide artificial insemination for a lesbian couple. The physician argued unsuccessfully that increased risks of litigation constituted a bona fide and reasonable justification for denying the service.     

Has the mortality of male doctors improved with the reductions in their cigarette smoking?

From 1951 to 1971 male doctors reduced their cigarette smoking more than did men in social classes I and II combined. In 1970-2, 665 male doctors died aged under 65. Had they shown the same improvements in cause-specific death rates over the 20 years as men in classes I and II, 699 deaths would have been expected. This "saving" of 34 deaths in the doctors comprised savings from coronary heart disease (83), stroke (16), and lung cancer (8) balanced by 60 "losses" from three stress-related causes--namely, accident, poisonings, etc (30); suicide (26); and cirrhosis of the liver (4)--plus 13 from other causes. As a relative reduction in mortality from heart disease in doctors (as compared with that in social classes I and II) also occurred during 1931-51--that is, before they began to give up smoking--some of the saving in heart-disease deaths in 1951-71 was probably not related to changes in smoking habits. The relative worsening in mortality from stress-related diseases may have been due partly to a possible adverse effect of giving up smoking if smoking had acted to reduce stress. From these findings, the benefits of giving up smoking may not be so great as has commonly been assumed.     

Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study.

OBJECTIVE--To evaluate the ability of doctors in primary care to assess risk patients'' risk of coronary heart disease. DESIGN--Questionnaire survey. SETTING--Continuing medical education meetings, Ontario and Quebec, Canada. SUBJECTS--Community based doctors who agreed to enroll in the coronary health assessment study. MAIN OUTCOME MEASURE--Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the \"average\" 40 year old Canadian man and 70 year old Canadian woman. RESULTS--253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P < 0.001). They showed a strong understanding of the relative importance of specific risk factors, and most were confident in their ability to estimate coronary risk. While doctors accurately estimated the relative risk of a specific patient (compared with the average adult) they systematically overestimated the absolute baseline risk of developing coronary disease and the risk reductions associated with specific interventions. CONCLUSIONS--Despite guidelines on targeting patients at high risk of coronary disease accurate assessment of coronary risk remains difficult for many doctors. Additional strategies must be developed to help doctors to assess better their patients'' coronary risk.