COVID-19 on the Big Island after vaccine availability

At Hilo Medical Center, there have been 0 Covid related hospitalizations for vaccinated individuals in recent weeks! This means that 100% of our hospitalized COVID-19 patients are unvaccinated, suggesting that here we see that vaccinations against COVID-19 are effective in preventing severe illness, hospitalizations and utilization of our limited resources and staff time.
There have been a few ED visits for flulike and related vaccine reactions, none serious.
As of 2 July 2021, we have 4 unvaccinated, COVID-positive patients in our hospital, 3 in our 11-bed ICU with 1 patient on a ventilator and 1 in our Obstetric Unit. 98% of hospitalized COVID-positive patients in our state are unvaccinated, and these still can get very very sick. Clearly the risk benefit favors vaccines at any adult age!
After all, currently we have about a 50 50 ratio of fully vaccinated to not people on island, and it's clear who the losers in that gamble are...

World distribution of mammalian coronaviruses: One reason the pandemic started in Wuhan

It's currently fashionable in many US circles to speculate that Covid-19 started in a Wuhan lab. But according to this 2017 paper, more coronaviruses are to be found in the regions around Wuhan than much of the rest of the world. The next SARS will also likely start in Asia, or perhaps Africa. That could have happened with or without help of a lab, and without a lab seems more likely at the moment.



Global patterns in coronavirus diversity

Simon J. Anthony, Christine K. Johnson, Denise J. Greig, Sarah Kramer, Xiaoyu Che, Heather Wells, Allison L. Hicks, Damien O. Joly, Nathan D. Wolfe, Peter Daszak

Virus Evolution, Volume 3, Issue 1, January 2017, vex012,

Published: 12 June 2017

Since the emergence of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrom Coronavirus (MERS-CoV) it has become increasingly clear that bats are important reservoirs of CoVs. Despite this, only 6% of all CoV sequences in GenBank are from bats. The remaining 94% largely consist of known pathogens of public health or agricultural significance, indicating that current research effort is heavily biased towards describing known diseases rather than the ‘pre-emergent’ diversity in bats. Our study addresses this critical gap, and focuses on resource poor countries where the risk of zoonotic emergence is believed to be highest. We surveyed the diversity of CoVs in multiple host taxa from twenty countries to explore the factors driving viral diversity at a global scale. We identified sequences representing 100 discrete phylogenetic clusters, ninety-one of which were found in bats, and used ecological and epidemiologic analyses to show that patterns of CoV diversity correlate with those of bat diversity. This cements bats as the major evolutionary reservoirs and ecological drivers of CoV diversity. Co-phylogenetic reconciliation analysis was also used to show that host switching has contributed to CoV evolution, and a preliminary analysis suggests that regional variation exists in the dynamics of this process. Overall our study represents a model for exploring global viral diversity and advances our fundamental understanding of CoV biodiversity and the potential risk factors associated with zoonotic emergence.

The map is not the territory

If consciousness is the territory, current AI is at best a partial map of that territory.

Rare and Common Presentations and Conditions

Common presentations of rare conditions are more common than rare presentations of common conditions.

What does the above even mean?

There are a very large number — thousands — of individually rare conditions. So even though any single given rare condition is only rarely seen, having any rare condition whatsoever is relatively common. On the other hand, there are a limited number of truly common conditions: the common cold, reactive depression, and back pain, for example.

According to the geneticists, “A rare disease is generally considered to be a disease that affects fewer than 200,000 people in the United States at any given time. There are more than 6,800 rare diseases. Altogether, rare diseases affect an estimated 25 million to 30 million Americans.”

If we consider a rare presentation of a common disease to be defined similarly, this would mean that this would likewise be about a 1 in 1500 presentation of a common condition. If 1/3 of the US population has at least one common condition at any given time, this means that about 100,000,000 persons in the US have a common condition; if 1/1500 had a rare presentation, this would in turn mean that there are only about 70,000 persons with rare presentations of common conditions per year. This is much less than the over 25,000,000 with a rare condition.

So it turns out that, based on prevalence data, the number of people with a rare but otherwise typical condition significantly outnumbers the number of people with only a rare presentation of one of the common conditions.

The anxious patient doing an unfortunate Internet search for their diagnosis may err because they choose a rare presentation of a rare condition over the common presentation of a common condition from which they suffer, and not because they find a rare condition that truly fits them best.

The machine runs on: "The Machine Stops" by yearend in 2021, we hope?

If you've never read E. M. Forster's classic The Machine Stops, written when the telephone was cutting edge tech, 2021 is the year you should.

See this link:

The Machine Stops

Let us not forget that social distancing is not social. Quarantine and related distancing is a necessary evil, and necessary evils are still, well, evil.

The dysfunctions promoted by our isolation under fear of the coronavirus should not be permitted to outlast the need for isolation. There are far better solutions incoming, such as immunization.

Sanbokan Marinade

The Sanbokan lemon is an heirloom variety of mandarin/pomelo cross which makes a great marinade for meat in the style of the Japanese ponzu sauces. Note that, here in Hawaii at least, the Sanbokan fruit is at is juiciest just as it begins to turn from green to yellow, and gets only slightly sweeter, but much less juicy as it ripens to bright yellow.


1 cup tamari (soy) sauce

1/2 cup Sanbokan lemon juice

2 teaspoons fresh ground pepper

4 cloves finely chopped garlic

Marinade steaks or pork chops for at least 2 hours, turning about every 15 minutes. Grill meat on both sides (gas grill preferred).

COVID-19 on the Big Island after vaccine availability

At Hilo Medical Center, there have been 0 Covid related hospitalizations for vaccinated individuals in recent weeks! This means that 100% ...