Category Archives: Stephen Golub

Benicia Author Stephen Golub: Our “Lucky Town”: Unvaccinated Americans Procrastinate and Protest, Unvaccinated Foreigners Perish

Today’s dominant delta variant is the 2020 version “on steroids.”

By Stephen Golub, A Promised Land, July 24, 2021

My Last Lecture

I taught courses on law and international development at Berkeley Law School and elsewhere for quite a while. On the last day of class each year, I’d end with what I considered my “lucky” lecture to the students. It went something like this:

Among other things, I hope that this semester you’ve learned something more than what you knew before about how unfortunate many people in the world are, about the inequities or deprivation they face. I hope you also appreciate how lucky you are, and that, going forward, you find ways of giving back.

No doubt, many or most of you have had major disappointments or pain in your lives. And if you haven’t, you certainly will sooner or later.

But still, the very fact that you’re smart enough and lucky enough to make it to Berkeley Law means that you won the lottery. Whether out of some sense of justice, or faith, or thankfulness, or whatever, please consider ways of aiding the less fortunate as you pursue your careers and lives.

OK, it’s not the Gettysburg Address. But I hoped it resonated for at least some of the students, particularly since they’d shown an interest in the wider world by taking the course to begin with.

 

Lucky Us

Those providential sentiments are on my mind as I consider people blind to their blind luck. Specifically, so many Americans still refuse their nearly miraculous anti-Covid shots while so many people abroad perish for lack of them: perhaps four million in India alone, according to a recent study. It’s a kind of American exceptionalism, you could say.

As Bruce Springsteen wrote in a song that celebrated his community (that is, America), lamented what it had become and hoped for better days,  “Son, we’re lucky in this town, it’s a beautiful place to be born.”

We know that America the Beautiful is a myth for many Americans, given the racial, economic, gender and other injustices plaguing our society.

But we’re still lucky, compared to the billions around the world who scrape by on a dollar or two per day, or don’t know where their next meal is coming from, or are brutalized by war, or lack even minimal control over their own lives…

Or don’t have any access to vaccines while so many Americans turn up their lucky, privileged noses at inoculation.

Some caveats: In some cases, the distrust of vaccines springs not just from Fox News propaganda or general anti-vaxxer wackiness, but from the medical profession’s historical mistreatment of Black Americans. For some folks, the hesitation isn’t political or historical; it instead reflects simple ignorance of the relative risks of the shots versus the contagion. Finally, it’s not just Americans displaying this attitude; many Europeans are as well.

Risks from the Shot Avoiders

Regardless, the impact of procrastination or even protests over vaccination remains. As does indifference to others’ wellbeing, including by otherwise caring persons. Because of course that avoidance or resistance doesn’t only put the unvaccinated in harm’s way:

  • As a former senior health adviser to President Biden put it, the delta variant is “the 2020 version of COVID-19 on steroids.”  With this much more contagious and possibly more virulent variant now dominant, the danger increases for the immunocompromised and for unvaccinated kids.
  • Large swaths of unvaccinated populations enhance the chances of vaccine-resistant variants emerging.
  • Even the vaccinated may face increased chances of falling ill. Fortunately, the risks remain extremely low for contracting severe cases of Covid if inoculated. But recent findings from Israel (so recent that their apparent conflict with previous research has not been resolved) suggest that Pfizer’s vaccine is not nearly as effective at preventing mild cases. And as one major medical center puts it, “Even a mild case of COVID-19 can come with some pretty miserable symptoms, including debilitating headaches, extreme fatigue and body aches that make it feel impossible to get comfortable.”
  • Vaccinated persons may contract Covid from the unvaccinated, remain asymptomatic and unknowingly spread it to immunocompromised persons or to kids.
  • There’s the looming question of whether even a vaccinated individual’s mild case can lead to “long Covid”: symptoms lasting for six months or longer.
  • Finally, our knowledge of Covid and vaccination remains in flux at this early stage (yes, in some ways it’s still early) of the pandemic. Certain risks I’ve listed here could prove minimal. Or they could prove more dangerous as we learn more – as that Israeli research may indicate – or as new variants emerge. There’s so much we just don’t know.

So what could all this add up to?

Three things:

Joy (or At Least Less Misery) to the World

We need massive and urgent action for the unwillingly unvaccinated across the globe. This can’t be said too often (which is why I’ve often said it): As both a humanitarian matter and a matter of self-interest, the United States should spearhead a campaign to vaccinate everyone in every country ASAP. True, there are some such efforts underway, most notably COVAX. But they are far from sufficient as to scope and speed.

It’s also true that the logistics of such an effort are daunting. But in its absence, many more millions may die.

For those Americans who can only see this in terms of, pardon the expression, America First, the proposed U.S.-instigated campaign would be in our own interest in at least a few ways. It would:

  • help limit mutations that yield vaccine-resistant virulent variants,
  • portray the United States as a beacon of help and hope in countless countries, and
  • mitigate potentially significant economic harm here and abroad.

A Shot in the Arm for the Unvaccinated

We can hope that most unvaccinated Americans will come to appreciate how lucky they are, how little it requires to accept a protective shot or two and how much it can mean to others for them to do so.

Even as I write this, though, I think to myself, “Good luck with that.” It’s time for increased policy responses – by  government, businesses and other institutions – that create more pressure to come around. Thankfully, such moves may be underway, though they clearly could take hold in some states than in others.

Questions for the Rest of Us

How do we deal with the unvaccinated? Simply accept that they see the world differently, as Democrats and Republicans sometimes do (though such acceptance has tailed off in recent years, given what’s become of the Republican Party)? Avoid the touchy issue entirely, just as some refrain from discussing politics with relatives who support Biden’s predecessor?

The matter becomes more problematic as it becomes more personal and immediate. It’s easier if we don’t know who’s gotten inoculated and who hasn’t, which is the case for most settings. Ignorance is a sort of bliss.

But what if we know folks who refuse vaccination?

To pick just one type of scenario: Should we invite unvaccinated relatives to weddings, parties or other events, even if outside, where people might be drinking, laughing, shouting and doing other things that could help spread the far more contagious delta variant? Make the invitation contingent on their getting the shots or providing proof of a negative Covid test?

Conversely, if invited, do we refuse to attend such an event if they’re there? Attend, but decline to sit near them or interact with them in such settings? Just accept the (slightly?) greater risks and the potential ripple effects of increased transmission? ­­

As one Florida vaccine hesitancy outreach coordinator (what a title!) recently put it, in advising on attending a large outdoor gathering where you don’t know if everyone is vaccinated (and presumably if you know some aren’t), it’s a good idea to don masks or remain socially distant: “[T]he delta variant has shown that it’s rampant and unforgiving in its ability to spread…When you talk about outdoor weddings and parks, I think physical distancing is still a good thing because an infected person may be asymptomatic.”

Fine. So how do you remain physically distant at a wedding party?

The fact that a large event is outdoors does not assure protection in these uncertain times. The experience of a recent Dutch music festival might shed some light. As an experiment, the organizers required that the 20,000 attendees prove beforehand that they were vaccinated, Covid-negative or recently recovered from Covid. Yet more than 1,000 tested positive afterwards.

Many more questions than answers here. Welcome to the far-from-Brave New World that the delta variant and the unvaccinated have helped create.


Stephen Golub, Benicia – A Promised Land: Politics. Policy. America as a Developing Country.

Benicia resident Stephen Golub offers excellent perspective on his blog, A Promised Land:  Politics. Policy. America as a Developing Country.

To access his other posts or subscribe, please go to his blog site, A Promised Land.

Benicia Author Stephen Golub – A Tale of Two Covids…

The pandemic news is both wonderful and horrible.

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.”
― Charles Dickens, A Tale of Two Cities

By Stephen Golub, A Promised Land, June 21, 2021

The Moonshot and the Bubble

Late last year, in discussing with me the rapid, successful development of anti-Covid vaccines, my cousin the doctor (and medical school professor, and very bright guy) – described the feat as a “moonshot.” I’d imagine others have also applied the term to that effort. But I’ll gladly give credit where credit is due for the first time I heard it used that way.

Indeed, the massively life-saving achievement merits the moniker. Just recall how grim the prospects seemed barely a year ago. A skeptical April 30, 2020 New York Times analysis dismissed the most optimistic predictions, of at least 12 to 18 months, as masking “a grim truth behind this rosy forecast…” It noted the inevitable steps and frequent missteps that make vaccine development typically a matter of many years rather than months – if it pans out at all.

In fact, Pfizer’s and Moderna’s trailblazing mRNA vaccines built on years of prior research, much of it government-funded. But churning out these medicines so quickly remains the equivalent of humanity landing on the moon. That so many of us are socializing, hugging and breathing so much easier right now seems miraculous.

We’re in a kind of bubble, though certainly one we should relish after a long, hard slog and not one that I’m predicting will burst. We’re not quite back to normal. But I’ll take quasi-normal over the thoroughly bizarre world that was 2020.

On June 15, California “reopened,” which means many though not all Covid restrictions have been relaxed. Here in the small, waterside city of Benicia, where I live, a new brewpub now welcomes patrons; it replaces a venerable café that closed during Covid. Tourists are tentatively returning to check out the local arts and gallery scenes. The other day, my wife and I gathered with some neighbors for bocce-and-wine for the first time in an awfully long time.

The city’s annual July 4 parade and fireworks remain canceled. But Benicia’s first Juneteenth celebration was a blast. The weekly Farmers’ Market has resumed, albeit with masks still required for the time being, as is (wisely) the case for going inside many businesses. Some folks still stroll down the main street masked – whether because they’re immunocompromised or out of simple, understandable caution.

At the same time, Benicia is part of Solano County, which has witnessed a slight rise in cases in recent days. As the indefatigable, heroic “Benicia Independent” blogger reminds us, after daily chronicling the pandemic’s course in the city and county for over a year, “COVID is still out there – TAKE CARE!”

In sum, it’s still weird and worrisome. But also oh so wonderful.

Meanwhile, Back on Planet Earth

Our bubble nonetheless floats amidst a world awash with Covid. While official tallies of daily death rates and total fatalities in India are “only” 1,200 and 390,000 respectively, these figures are probably vast undercounts. An accurate conservative estimate would double those Indian numbers; the actual fatality total there could even be over four million and climbing. Meanwhile, Brazil’s official death count has now topped 500,000, second only to 600,000 in the United States. (We’re Number One.) But, as in India and other nations, both of those figures likely underestimate the true tolls. We actually could be pushing one million deaths in America alone.

The picture in many other parts of the globe is also daunting. With less than one percent of its population vaccinated, Africa is experiencing a surge of cases; 22 countries reported increases of 20 percent last week. Peru may have the worst per capita mortality rate in the world, while parts of East and Southeast Asia that dodged the Covid bullet earlier on are reeling now. Though they remain in better shape than many other countries, there have been troubling outbreaks in Taiwan, Thailand, Vietnam and especially Malaysia.

Meanwhile, the prevalence of the Delta variant, originally identified in India and more transmissible and dangerous than the original virus strain, grows both abroad and at home. This comes even as the fully vaccinated rates remain below 35 percent in several, mainly southern states. While fully vaccinated folks thankfully are at very low risk from this mutation, the protection drops substantially for those who have only had their first jabs from the two-shot regimens.

Those of us living in relatively inoculated states and nations occupy not only geographically privileged places. We also may be living in temporal bubbles (admittedly a Star Trekkish term) as well. With the Delta and potentially other variants’ rates rising, and so many Americans remaining unvaccinated, we could see a spike in deaths as those mutations spread and when autumn and winter force more people indoors.

It’s tempting to shrug our shoulders and leave willingly unvaccinated Americans to their self-selected fates, even as each illness and death is a tragedy. But exposure to unvaccinated Americans puts immunocompromised people, kids who can’t get shots and other populations in substantially greater danger, as well as slightly increasing risks for the inoculated.

Another Moonshot

Against this backdrop, late last month the leaders of the World Bank, the World Health Organization and other institutions called for a crash program to increase vaccine supply and distribution, so as to vaccinate the globe as fast as possible. The subsequent pledge of President Biden and other world leaders to donate a billion doses to poorer nations falls far short of satisfying that need. It’s been justifiably criticized by the WHO and other authorities.

The pledge is disappointing as a humanitarian, economic and even self-interested matter. The longer Covid rages around the world, the greater the chance that vaccine-resistant variants can arise, threatening us all. It’s true that one of the miracles of mRNA technology is that it can be adapted to neutralize new variants. But untold human and financial prices could be paid before that happens.

In other words, we need that crash program. We need another moonshot.

One closing thought for the unvaccinated (and the rest of us) in the United States: If there was ever a time for Americans to appreciate what we may take for granted and what people elsewhere would practically die for – and are literally dying without – this is it.


Stephen Golub, Benicia – A Promised Land: Politics. Policy. America as a Developing Country.

Benicia resident Stephen Golub offers excellent perspective on his blog, A Promised Land:  Politics. Policy. America as a Developing Country.

To access his other posts or subscribe, please go to his blog site, A Promised Land.

Benicia Author Stephen Golub – In the wake of the January 6th insurrection…

Memorial Daze

In the wake of the January 6th insurrection, Republican leaders want us to sleepwalk through history as they desecrate the graves of the fallen.
By Stephen Golub, A Promised Land, May 31, 2021

From a National Holiday to 1984

Memorial Day honors Americans who died while performing their military duties in our armed forces. This year, it is accompanied by attempts to make Americans sleepwalk through history.

The holiday arrives but three days after Senate Republicans blocked the formation of a bipartisan commission that would have investigated the January 6th Capitol insurrection. And it comes just one day after the Texas Legislature tried but temporarily failed to adopt one of the most stringent voter suppression laws in the country.

What we have, then, is a national holiday commemorating our history, following on the heels of a major political party seeking to deny it.

As former Republican George Will put it, “I would like to see January 6th burned into the American mind as firmly as 9/11 because it was that scale of a shock to the system.” Yet in filibustering the commission into oblivion, Senate Minority Leader Mitch McConnell and company sought to minimize a day that, like both 9/11 and Pearl Harbor, should live in infamy.

Even worse, the move seeks to prevent our fully finding out what happened that day. What did Donald Trump know and do – or deliberately fail to do – while the Capitol was under attack? Who else failed to act, and why? What kinds of collaboration might have been going on among the rioters and with outside forces?

Then there’s the Texas legislation, temporarily derailed when Democrats walked out and denied the Legislature a quorum, but sure to resurface and most likely pass when Gov. Greg Abott calls a special session later this year. Among other things, the bill “included new restrictions on absentee voting; granted broad new autonomy and authority to partisan poll watchers; escalated punishments for mistakes or offenses by election officials; and banned both drive-through voting and 24-hour voting, which were used for the first time during the 2020 election in Harris County, home to Houston and a growing number of the state’s Democratic voters.”

It’s but the latest and perhaps most ambitious of the like-minded slew of democracy-gutting proposals that Republican-controlled state governments are pushing into law across the country in preparation for the 2022 and 2024 elections.

It’s also part and parcel of the Republican effort to promote the Big Lie, still bought by 61 percent of Republicans in a national poll just two weeks ago, that the election was stolen from Donald Trump. The circular justification for the voter suppression in Texas and elsewhere is that in the wake of 2020 people have doubts about election integrity – doubts spurred by the Big Lie and its associated prevarications.

It’s all so 1984. But in addition to Ignorance is Strength, we have lies are facts. Instead of a Ministry of Truth, we have Fox News going even more whole hog to promote this hogwash in response to viewer encroachment by Far(ther) Right outlets Newsmax and One America News.

Why Did They Die?

And we have an ongoing attempt to erase recent history and memory.

Which brings us back to today’s holiday. The Americans mourned on Memorial Day gave their lives for many things: their country, their communities, their families, their friends, the folks in their squads. A more cynical take would explain some deaths in terms of their leaders’ sometimes dubious foreign policy goals.

Regardless, one thing many died for – or at least felt they were dying for – is democracy. What an irony that they fell defending it abroad only to have it threatened here at home.

In downplaying and perpetrating the greatest internal attacks on our democracy since the Civil War, congressional Republicans and other Party leaders are desecrating the graves of the fallen.

Let me be clear: I’m not attacking the many, many Republicans who have served and love America. But with shockingly few exceptions, the Party’s leaders have made the GOP into something shockingly destructive.

And for what? No grand principle. No crying need. Just the tawdriest of causes: to fuel and appease some voters’ repugnance against people who supposedly don’t belong; to cling to power and perks at all costs; to sell their souls for 30 pieces of political silver.

History Is What We Make It

But the story does not end there. We’re not helpless in the face of these attempts to flush recent history down the toilet. We can donate, campaign, educate and otherwise act to combat the danger. Texas Democratic legislators scored a victory of sorts by delaying the voter suppression vote and ensuring it will get renewed scrutiny down the line. Congress’s Democratic leaders can go ahead and appoint a select committee to investigate January 6th, pointing out that they gave the Republicans every fair chance to go bipartisan.

We can be active participants in history, not simply observers. To act otherwise is to accept defeat in the middle of the battle.


Stephen Golub, Benicia – A Promised Land: Politics. Policy. America as a Developing Country.

Benicia resident Stephen Golub offers excellent perspective on his blog, A Promised Land:  Politics. Policy. America as a Developing Country.

To access his other posts or subscribe, please go to his blog site, A Promised Land.

Benicia Author Stephen Golub – The Four Covid Questions, Israel and Good Vaccination News

Along with lots of caveats.

By Stephen Golub, A Promised Land, February 24, 2021
This won’t hurt a bit. (Photo by Dick Knapp)

In a week when America’s Covid fatalities topped 500,000 – an official figure that might actually understate the real toll and that in any event represents more than all of our overseas wars’ combat deaths combined – it seems incongruous but useful to summarize some good vaccination news.

So here goes.

Arguably the most important data right now (and in weeks to come) comes from Israel, which is way ahead of all other countries in its vaccination rates by virtue of a deal it cut with Pfizer. That arrangement features use of the country’s sophisticated national health care system to not only efficiently administer shots but to collect and analyze “real world” data that is even more valuable than that gathered through clinical trials.

In any event, for months I’ve had four questions about Covid vaccinations’ effectiveness. Here they are, along with preliminary answers gleaned from news reports and research analyses.

1. How likely are we to fall ill even after being vaccinated?

Vaccines vastly reduce our chances of falling ill at all. Even more important, they seem to reduce hospitalizations and deaths far more, to miniscule percentages.

As explained in this analysisnone of the approximately 74,400 people who received inoculations in five clinical trials (including for the Pfizer, Moderna and about-to-be-approved-for-the-USA Johnson & Johnson vaccines) were hospitalized or died.

Multiple reports from Israel in recent weeks are similarly favorable. The most recent one determined that Pfizer’s product has been just as effective when administered on a massive scale there as it was during clinical trials. Other details emerged a week ago:

An Israeli healthcare provider said on Wednesday that Pfizer Inc’s COVID-19 vaccine was 95% effective in a trial of 602,000 people, reinforcing the drugmaker’s efficacy findings.

Israeli HMO Maccabi, which covers over a quarter of all Israelis, said in a statement that only 608 people had tested positive for COVID-19 more than a week after receiving the second of two required Pfizer doses.

The comparison was against a group of 528,000 Israelis with similar backgrounds who did not receive the vaccine, Maccabi said. Of those, 20,621 tested positive…

Most of the 608 infected vaccinees reported only mild symptoms, such as a headache or cough, Maccabi said. Some 21 required hospitalisation, seven of whom had severe symptoms, it added.

The New York Times’ Dave Leonhardt assesses this data in a comparative manner:

Here’s a useful way to think about Israel’s numbers: Only 3.5 out of every 100,000 people vaccinated there were later hospitalized with Covid symptoms. During a typical flu season in the U.S., by comparison, roughly 150 out of every 100,000 people are hospitalized with flu symptoms. [Emphasis in original.]

Now, there’s some apples-to-oranges inexactness here, including the time frames involved and his comparing vaccinated Israeli Covid patients with an American flu patient population that apparently includes unvaccinated persons. Still, the point is that our vaccinated Covid risk may be approaching a level most of us might find acceptable.

2. How probable is it that we can spread the virus to unvaccinated people after we’re vaccinated?

The data here is not as firm as for question #1. But preliminary research indicates that if you’re vaccinated you’ll run a significantly reduced risk of transmitting the virus to unvaccinated folks.

As explained in this excellent piece, initial indications from Israeli and United Kingdom research strongly suggest that at least the Pfizer vaccine (and presumably Moderna’s as well, since it’s so similar) strongly reduces our chances of being infected with the coronavirus at all. This vaccination also seems to reduce our viral loads in our noses and throats, even if infected. The upshot is reduced risk to unvaccinated people.

In other words, as per that piece:

In total, vaccination unambiguously makes people less likely to get a case of Covid-19. Then, if a vaccinated person does get a Covid-19 case, preliminary Pfizer data from Israel suggests they’ll have lower viral loads, which other research has established makes them less likely to pass on the virus. And because of the lower viral load, if they do infect another person, the infection is less likely to be serious.

Another analysis reaches similar conclusions.

3. Do the South African, U.K and other variants change the answers to #1 and #2?

A proliferation of new Covid variants that may be more transmissible or otherwise deleterious to health has triggered considerable concern about whether and how effectively vaccines will work against them. Fortunately, there’s some encouraging though admittedly tentative evidence that vaccines perform effectively against variants, perhaps in preventing illness but at least in terms of preventing hospitalization and death.

Research in Israel indicates that the Pfizer vaccine is effective against the U.K. variant.

There is also good news regarding the South African strain. The Johnson & Johnson vaccine performed well there in clinical trials. Moderna has announced the development of a modified vaccine tailored against that variant, though it remains to be tested.

It’s true that the South African government suspended use of the AstraZeneca vaccine on the basis of a small study suggesting that it does not prevent mild or moderate cases. But the World Health Organization recommends use of the vaccine against that and other variants on the grounds that it seems effective at preventing “severe illness, hospitalizations and death, including from new variants.”

In addition, Pfizer and Moderna (using its original formula) laboratory research indicates likely effectiveness against South African and other new variants. But since these are small-scale and not clinical studies (which use human volunteers), perhaps the findings should be viewed with particular caution.

Not all the variant news is good. A rapidly spreading California strain appears to be more transmissible than the “normal” variant.

But this bad news is not totally bad. Not all experts see this as being as easily transmitted as the U.K. variant. And even the doctor leading some of the research on it predicts that vaccines should be effective against it.

4. When Can We Hug Each Other Again?

Or, more specifically, when can we hug family and friends from outside our pods, if they and we are all vaccinated? The question becomes all the more salient as Pfizer and Moderna pledge to ramp up vaccine production and availability dramatically over the next five weeks.

To my mind, this is the biggie, the greatest sign of a return to some semblance of normal, of stepping out of our caves and into the sun. In one recent article, “Ashish Jha, the dean of Brown University’s School of Public Health, told [the author] that in a month or so, in the absence of a variant-driven surge, he’d probably be comfortable going to a friend’s house for a drink, mask-free and indoors, if he and his friend were both fully vaccinated.”

It’s a judgement call, tinged with some powerful emotions. Some experts are no doubt reluctant to endorse plans like Jha’s yet (even if some of them might be pondering the same actions), for fear of being or seeming irresponsible. Others, as well as non-experts like me, might be chomping at the bit, but still want to see more data come in regarding risks, transmissibility and variants.

The simple answer is that the answer isn’t simple. But the biggest good news is that we can finally ask the question.

Lots of Caveats

One huge caveat to all of the above is that we’re only starting to study and understand the vaccines’ impact on the virus within the general population, as opposed to the data from various pharmaceutical firms’ control trials. Lots can change. We’ll know far more some months from now.

Another regards the variants. The tentative good news could be swamped, should new strains arise that are more transmissible, deadly or, especially, vaccine resistant. On the other hand, modified vaccines that protect against new strains (as with the Moderna variation for the South African strain) can be developed in a period of six weeks, though getting them federally approved and then ramping up production would take additional time.

A third is that massive inequities plague the distribution of vaccines in America and abroad. These must be addressed as a matter of basic humanity and fairness, but also as a matter of protection against the growth of potentially vaccine-resistant variants.

As a final caveat, consider the source here – that is, me. I’ve done my best to summarize some complex information. But I’m just a layperson, and not an especially scientifically swift one at that.

However, I did stay at a Holiday Inn Express last night:

Stay safe and healthy, everybody.


Stephen Golub, Benicia – A Promised Land: Politics. Policy. America as a Developing Country.

Benicia resident Stephen Golub offers excellent perspective on his blog, A Promised Land:  Politics. Policy. America as a Developing Country.

To access his other posts or subscribe, please go to his blog site, A Promised Land.