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Wednesday, November 24, 2021

Topol and Osterholm: The CDC got it wrong. It should have urged all adults to get covid-19 booster shots.

 The Washington Post


 

By Eric J. Topol  and  Michael T. Osterholm

Eric J. Topol is a professor of molecular medicine at Scripps Research. Michael T. Osterholm is Regents Professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.


Even though the United States is experiencing a new surge of covid-19, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommended last week that all adults be made eligible for booster shots but only urged shots for people older than 50.

 That was a big mistake. It should have urged all adults to get them.

 Public health officials have always expected that mRNA coronavirus vaccines (Moderna and Pfizer/BioNTech) to be a three-shot regimen. The only question was when the third shot would be necessary. Originally, the hope was that it would be after one or two years. It turns out, it is necessary at about six months.

 More than 10 large reports have shown that the reduced protection from infections, including symptomatic infections, across all age groups, wanes from 90 to 95 percent at two months down to about 60 percent for Pfizer and 70 percent for Moderna after five to six months. There is further substantial waning after six months.

 

The good news is that a booster dose can restore that initial efficacy, as data makes abundantly clear. One randomized trial of Pfizer’s vaccine involving more than 10,000 participants — half receiving a third shot and the other half receiving a placebo booster — showed a remarkably high 95-percent efficacy. In that trial, people aged 18 to 55 benefited just as much as those older than 55. There were no safety issues raised, such as myocarditis.

 

It is important to underscore that for all coronavirus vaccine trials, symptomatic infection has been the primary endpoint, and has tracked well with hospitalizations and deaths. Large, randomized trials are rightly considered the gold standard form of evidence. There are no other randomized trials of booster shots underway.

 

Israel offers more evidence of the booster’s benefits. Its largest health system tracked more than 700,000 people who had received a booster shot and found that the third shot had a striking 91 percent effectiveness against symptomatic infection. It also had a 93 percent effectiveness against hospitalization and 81 percent effectiveness against covid-related deaths.

 

But the CDC’s advisory committee didn’t review this important observational study and many other relevant data sources. If it had, perhaps it would have more forcefully advocated boosters for all adults. Our recommendation is fully consistent with messaging from the White House and President Biden that all vaccinated adults should get boosters.

 

Its failure to do so has substantial implications. Only 59 percent of the U.S. population is fully vaccinated, meaning the United States ranks below the top 50 most-vaccinated countries. Countries throughout Europe, such as Denmark and Belgium, have vaccination rates of around 75 percent, and even they are experiencing record-setting surges in cases.

 

Like Britain and Israel, the United States was a first mover with early vaccination campaigns, so it has a much higher proportion of people with waning immunity. Forty percent of Americans (more than 120 million people) were fully vaccinated by June 1 and have diminished protection. Each day in the United States, the number of people with waning immunity greatly exceeds those who are getting newly vaccinated. Accordingly, rather than building our wall of population immunity, the United States is suffering attrition.

 

It has been estimated that more than 90 percent of Americans need to be fully vaccinated to contain the hyper-contagious delta variant. Not only are we far from that goal, but also we are moving in the wrong direction. While we continue to press ahead to reach unvaccinated Americans, we must concurrently maintain protection for those who have received the shot.

 

This is especially concerning amid the new surge, which has been labeled a “pandemic of the unvaccinated.” This is misleading; it is critical to recognize the category of “vaccinated but waned.” Multiple studies have shown that fully vaccinated people can spread the delta variant. This is more likely when the vaccine-induced immune response has faded. Since booster shots strongly reduce symptomatic infections, they could help stem the increased spread that we are experiencing.

 

Israel used booster shots for all adults as its principal — and highly effective — strategy to manage its worst surge of the pandemic. There, the status of “fully vaccinated” is defined as having received three shots. Indeed, the United States has consistently ignored critical lessons from Israel and Europe throughout the pandemic.

 

By not strongly urging all fully vaccinated adults to get a third shot, the CDC has failed its responsibility to protect the public, fundamentally missing a strategy that would limit the surge in cases — not to mention the toll it will have in terms of long covid-19 and hospitalizations. It has also engendered confusion by not keeping its recommendation simple, suggesting an illusion that there is a sharp age gradient for the benefit of boosters, which is clearly not the case.

 

Now, as we confront yet another surge, it is not the time to withhold a vital and validated means of boosting our efforts to contain the virus.


 

 

Saturday, November 20, 2021

Michael Oren: Why Israel may soon attack Iran

The Times of Israel

  

The world's largest state-sponsor of terror, sworn to destroy Israel, is approaching the nuclear threshold. It's not an existential threat for the US. It is for Israel.


Later this month, representatives of the world powers and Iran will meet in Vienna to discuss reviving the 2015 Joint Comprehensive Plan of Action Cooperation – the Iran nuclear deal. In the runup to the talks, the United States and Israel have reiterated their determination to prevent Iran from producing nuclear weapons. Both have stated their preference for a diplomatic means of achieving that goal. But there the symmetry ends. While the United States can live with an Iran that has the ability to make a bomb but doesn’t do so, Israel simply cannot.

The disparity was clear at a recent press conference with Secretary State Anthony Blinken and Israeli and Emirati counterparts. Blinken reiterated his administration’s longstanding insistence that “Iran cannot be allowed to acquire a nuclear weapon.” By contrast, Israeli Foreign Minister Yair Lapid warned that “Iran is becoming a nuclear threshold country,” and that Israelis “have no intention of letting this happen.”

What is the difference between an Iran that could quickly make a bomb and an Iran that already has one? Why would America implicitly accept a threshold-capable Iran while Israel regards it as a strategic – and potentially existential – threat?

“Threshold” describes a nuclear program that has all the components necessary for swiftly making a bomb. Enriching uranium to the 90% level necessary for weaponization takes as much as two years. But by enriching uranium to 60%, as it does now, Iran has completed the longest stretch of the process and is now installing centrifuges capable of spinning four or even six times faster than the current rate. Once it decides to break out and create a nuclear arsenal, Iran can do so in a matter of weeks or even days – well before the international community could react.

And Iran will inevitably break out. Several countries have what is sometimes called “Japan-like capabilities,” a reference to Japan’s own threshold nuclear program. But Japan is not Iran, a country ruled by the world’s largest state-sponsors of terror, which works to overthrow pro-Western governments, and vows to wipe Israel off the map. Having the ability to make a bomb, no matter how quickly, will not suffice for Iranian rulers. They saw what happened to Saddam Hussein in Iraq and Libya’s Muammar Qaddafi, both of whom forfeited their nuclear ambitions and died, and what didn’t happen to Kim Jung-un, who kept his and become almost untouchable. Yet, beyond regime survival, the bomb is vital for Iranian prestige. A weapon possessed by Sunni Pakistan, Hindu India, and, presumably, by the Jewish State cannot be denied to the Shiite Islamic Republic.

Yet Iran does not have to possess the bomb to damage Israel irreparably. Threshold capacity provides Iranian-backed terrorists with a nuclear umbrella that can open and shield them from retaliation. Responding to rocket attacks from Hezbollah or Hamas, Israel will be hobbled by the fear of an Iranian breakout. Defending the country will be dangerously more difficult.

Such fears are much less pronounced in the United States, a country situated far from Iran and not threatened with national destruction – a United States which, moreover, has no desire to become embroiled in another overseas conflict. For that reason, the Biden Administration pledges to prevent Iran from acquiring nuclear weapons but not to prevent Iran from attaining the ability to make them. For that reason, President Biden vows to consider “other options” should Iran not return to the negotiating table but does not echo President Obama’s warnings of “all options are on the table,” including a military strike.

Israelis view this policy with profound skepticism. A threshold Iran will drive other Middle Eastern states to attempt to achieve the same capability, creating a highly unstable region teetering on a nuclear threshold. Together with its continuing efforts to produce a deliverable warhead – amply documented by the nuclear archive Israel’s Mossad secreted out of Teheran – Iran has developed intercontinental ballistic missiles that can already hit central Europe and will eventually reach the North American coast. Global security will be undermined.

For Israel, though, the timetable for action is much shorter, and while our military capabilities cannot equal America’s, we do have the means to defend ourselves. And though Israel has no expectations of US military intervention, we trust that the United States will provide us with the logistical, diplomatic and legal assistance we need and stand by all its Middle Eastern allies. Doing so will not only deal a decisive blow to Iran’s nuclear ambitions but will also restore America’s regional prestige.

As the nuclear talks resume, Israel will be watching to see if Iran exploits them to camouflage its march toward threshold capability. If so, irrespective of the international backlash, Israel will be forced to act. Recalling that both he and the Secretary of State are the sons of Holocaust survivors, Lapid stressed the need for nations to protect themselves against evil, and especially against an Iran sworn to destroy the Jewish state. “Israel reserves the right to act at any given moment, in any way,” he said. America, and the world, should listen.

ABOUT THE AUTHOR
Michael Oren was formerly Israel’s ambassador to the United States, a Member of Knesset, a deputy minister in the Prime Minister’s Office. His latest book is, To All Who Call in Truth (Wicked Son, 2021).

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Michael Oren is the only Israeli politician apart from Bibi who quoted Bernard Lewis's warning on Iran and MAD: 

Michael Oren: Why Obama is wrong about Iran being 'rational' on nukes


As famed Middle East scholar Bernard Lewis once observed, “Mutually assured destruction” for the Iranian regime “is not a deterrent — it's an inducement.”

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It was already clear in 2008 that this would happen. My article from then:

Facing Iran, Alone




Tuesday, November 16, 2021

Not Mata Hari

Mata Hari

Richard Sorge

Eli Cohen




Jerusalem Post Letters to the Editor, November 17, 2021

Not Mata Hari

Regarding “Turkey allows visit by consul to jailed Israeli couple” (November 16), this whole incident is just too much. For heaven’s sake, if Israel can assassinate Mohsen Fakhrizadeh using a computerized machine gun, bring from Iran half a ton of nuclear files, disrupt the centrifuges through Stuxnet, then surely it does not need to photograph Erdogan’s palace from a TV tower.

We do not live in the times of Mata Hari and invisible ink, not even in the times of Richard Sorge or Eli Cohen, so what the Israeli media should have done is demonstrate how absurd the Turkish claims are.

It is also high time that Israelis become more conscious of the character of the countries they go on vacation to. Why pick one ruled by an Islamic fundamentalist with a very antagonistic attitude toward Israel when they can choose from a number of Mediterranean democracies? Appeasing dictators is never a good policy and that applies not only to governments but to their citizens too.

MLADEN ANDRIJASEVIC

Beersheba



And here are the Mediterranean democracies Israelis could pick to go on vacation to instead of Turkey. Note that it applies only to The Republic of Cyprus and no the Turkish Republic of Northern Cyprus










Saturday, October 30, 2021

Debating COVID-19 Vaccine Boosters

 


Eric Topol: 


There was denial. There was criticism of the Israeli Ministry of Health and the researchers there. There were statistical controversies like Simpson’s paradox, and basically it was rebuked.  




Well, two weeks later a more thorough report with more data came out and it was even more concerning. Because now the breakdown was that symptomatic infections, the protection, vaccine effectiveness had dropped down to 41 percent. 













Sunday, October 17, 2021

Yossi Cohen: "Iran not close to getting a nuclear bomb". But the mid-October date talked about by Gantz and Bennett is NOW!

 


Israel is coming up with contradictory messages on the date when Iran will be getting close to producing a bomb, acquiring enough enriched uranium on the one hand and the time to actually make the bomb once there is enough enriched uranium on the other.  Gantz and Bennett have said that the deadline for getting enough uranium is mid- October, which is today. Amb Dore Gold says it is now since work was not done sequentially but in parallel.   Yossi Cohen says they are not even close.

Whom to believe?

Perhaps this may be intentional to create confusion.


Wednesday, October 13, 2021

The Pompeo Doctrine - The Lie of Occupation.

 Israel exists within its present territory with full legal title and sovereign legitimacy as a matter of international law.

From 3:26 to 4:47  ( my transcript until the official one becomes available )  

As we all know, a concerted campaign is being waged against the world's one and only Jewish country, attacking virtually every aspect of its historic, legal, political, cultural life with the singular aim of undermining the sovereignty, security and legitimacy of Israel’s existence.

The future of our nations demands a more forceful assertion of the truth. The truth at the level that we have not seen spoken about or witnessed, in Israel’s case it specifically involves confronting a false narrative that is the very beating heart of modern antisemitism. That beating heart is the lie, the lie that the State of Israel is an illegal occupier in the Land of Israel

The lie of occupation. The lie of occupation provides Israel’s enemies a means to explain away all types of aggression and violence as merely resistance to the occupation. Just listen to what they have to say at the public rhetoric, given the negative connotation of the term “occupier”, antisemitic groups around the world use the word as often as possible in their messaging, as they carry out acts of cultural, political and economic warfare upon Israel and its supporters.

Occupier! Occupier! This then leads to the term’s casual repetition by the media and its eventual use by policymakers as well. This presents real risk. It is clear. It is clear then that promoting the common misrepresentation of the Jewish State of Israel as an occupier in the Land of Israel has become the primary antisemitic canard of the present generation.

The bottom line. The bottom line is that occupation is a legal term, whose definition does not apply to the State of Israel under the law.

Nevertheless, the term is intentionally misused, and it’s important that we know this. It is intentionally misused in order to shape negative misperceptions of Israel’s history and its legitimacy while perpetuating a sense of Arab victimhood.  In this very same context, occupier is nothing more than a polite way of calling Israel a thief. It goes hand in hand, hand in hand with the denial and erasure of Jewish history to international institutions such as the United Nations.

To Christians, of course, this means as if the two Jewish Temples never stood on the Temple Mount in Jerusalem, then Christ and his works are then equally invalidated.

One of the things I worked hardest as my time as America’s Secretary of State was to set that record straight. To clarify all the chaos that had been sown. You should know that the situation I inherited in the State Department was a policy mess that had been festering since the time of the Carter administration, based on ignoring inconvenient legal history.

You know, as Senator Daniel Patrick Moynihan, not from my party, put it: “a person is entitled to his own opinion but not to his own facts”. So I told my team at the State Department to conduct a strict factual and legal review, and policy analysis which then formed the basis for our policy stance. In practical terms this ultimately meant confronting the lie of occupation with the truth. The truth that Israel exists within its present territory with full legal title and sovereign legitimacy as a matter of international law.     


Tuesday, October 12, 2021

Sally Rooney, Sartre and Camus

 


Letters to the Editor, Jerusalem Post, October 13, 2021

Loony Rooney boycott move

Regarding “Israel Boycott: Sally Rooney won’t let novel be published in Hebrew,” (October 12), let’s face it, some people are just dense when it comes to politics. Jean-Paul Sartre supported president of the People’s Republic of China Mao Zedong when during the years he was in power some 65 million people were killed.

But there were novelists who were not blind, like Albert Camus.

As for Sally Rooney, one must really be illiterate not to see from the very name of the Palestinian Islamic Jihad what this is all about. Not surprising, coming from Ireland, whose prime minister de Valera had visited the German Legation in order to sign the book of condolences on the death of Adolf Hitler.

MLADEN ANDRIJASEVIC

Beersheba


In the letter I sent it just said Mao. The editor changed it to “president of the People’s Republic of China Mao Zedong”. Except that Mao was not the "president of the People’s Republic of China". He was the Chairman of the Chinese Communist Party.  I know that people living in Israel today probably would not even notice the difference, but anyone who has some idea how communist systems function would notice the inaccuracy. In communist countries the Party reigns supreme.