Sunday, February 28, 2021

How do we know the vaccines are actually working?

I have been gamely trying to understand just how we know that the COVID-19 vaccines are actually working. I read reports and articles assuring me that that is the case, but how do we actually know?

Surprisingly, it's not easy to ascertain. Perhaps the best overall article I have found about how efficacious and effective the new vaccines are is this one, produced for the UK Parliament. The first thing to note, then, is the difference between vaccine efficacy and effectiveness.

Vaccine efficacy is what is measured during randomized controlled clinical tests, before a vaccine is licensed and released, which compare the rates of infection between vaccinated people and those receiving a placebo. This I understand, and this is where figures like 94% for the Pfizer/BioNTech vaccine come from. It is a kind of theoretical measure, based as it is on mainly healthy younger volunteers and only over a relatively short timespan.

Vaccine effectiveness, on the other hand, is a more real-world measure, evaluated during post-license observational studies of the whole population of vaccinated people of all different ages, health profiles, etc, over an extended period. This may be quite different from the theoretical efficacy rate, and this really is the one that counts. But it is notoriously hard to pin down. How do you measure it in practice? Is it just the proportion of vaccinated people who catch the virus compared to the proportion of those unvaccinated people who test positive?

The only published study I have seen so far comes from Israel, and concludes that the Pfizer/BioNTech vaccine is around 50% effective in preventing transmission, and just 33% effective for adults over 65 years of age. Scientists seem pleased with this, but it is light years away from the 94% theoretical efficacy. Britain, which also started vaccinating quite early, says it will not be able to produce any useful effectiveness figures until late February at the earliest, although an early analysis suggests that just the first dose of the Pfizer vaccine reduces the risk of infection by around 70% (57% on those over 80). A Scottish study has shown an 81% reduction is hospitalizations among vaccinated seniors over 80. These are, however, not very exhaustive or conclusive results. 

So, what are the (mainly non-scientific, political) claims that "the vaccines are working" based on? Just the fact that new cases have been falling in recent weeks? (I had hoped this was due to public health measures and the lockdowns we are all putting up with.) The recent fall in hospitalizations and deaths? (Is that not because we are getting better at treating the infections that do occur?) 

What is the so-called "real world" data that many of the more cavalier scientists are touting? Merely comparing the hospitalization rates of those who have had the vaccine with a completely different group of unvaccinated people, who may have different health, age and socioeconomic profiles. This is hardly controlled, double-blind testing.

Then, of course, there is the whole issue of whether the vaccines are "sterilizing vaccines" (ones that actually prevent infections and transmission completely) or "disease modifying vaccines" (that just reduce the severity of the disease when it is contracted). There is the issue of the duration of the immune response. There is the whole issue of what we are looking for in a vaccine: a cessation of transmission and carriage of the virus, or just a reduction in the numbers of hospitalizations, or of deaths? The whole field is rife with gradations and definitions and assumptions and what have you.

Everyone claims to be "following the science" and "basing decisions on the data", and yet we have widely different policies arising, e.g. some countries and provinces are happy to give AstraZeneca to seniors, while some are not; some are waiting the manufacturer-prescribed three or four weeks (or up to six weeks) between doses, while some are waiting three months, even four months, in between. All still claim to be "following the science". At this point, "the science" becomes a very murky and imprecise concept indeed.

The bottom line, though, is that any functional vaccines are better than none, and I'm certainly not going to turn any down. Some people will, though, and there have already been differences in what some countries are willing to accept in a vaccine (e.g. South Africa has rejected the AstraZeneca vaccine because it has not been shown to be effective enough against the South African variant, and France and Germany are not using it on over 65s because of a lack of testing on that age group, despite some evidence from the UK that it is effective on seniors). It's a real scientific minefield. 

Saturday, February 27, 2021

Public health officials are starting to unravel in battle against variants

Like in a bad Hollywood movie, the variants are coming! Nay, they're here already, they're everywhere!

First there was the British variant, then the South African variant, and the Brazilian variant. Then the original British variant had to be renamed as the Kentish variant (in Britain at least), because there was now  a Liverpool variant and a Bristol variant as well. In the US, there was a nasty California variant and a mid West variant.

And now, following that bad Hollywood script, there is a new variant of concern first identified in New York City, a particularly nasty one that can apparently protect itself against antibodies and vaccines. And people are getting well and truly fed up with the whole variant thing. One New York public health advisor referred to it as "pathogen porn", and cautioned researchers to "please review high impact studies w/govt health depts before marketing it to [the] media".

Ouch, tetchy! Maybe it makes for a good soundbite, but those researchers are pedalling as fast as they can, and it is, after all, their job to alert public health authorities to anything that might conceivably help them, and in as timely a manner as possible. The New York variant now makes up over 12% of positive tests in New York and surrounding areas (as of mid-February), so it is not insignificant, and people need to know about it. 

I get it that public health officials are tired and approaching the end of their tether after a year of battling against this virus. But, hey, don't shoot the messenger. That's not going to help anybody.

Thursday, February 25, 2021

A typeface that helps you remember what you type

Researchers at RMIT University in Melbourne, Australia, have developed a typeface that they say is "scientifically proven" to help you remember what you type

Or, more specifically, what you read. Sans Forgetica (ho, ho, ho!) is a reasonably notrmal sans-serif typeface with some chunks strategically snipped out of the letters. This makes it harder to read than most typefaces (but not TOO hard to read) which, psychologists say, means that you have to work harder at reading it, thus helping you retain the content better.

Of course, writing by hand also works...

P.S. I have used the word "typeface" here advisedly, because I believe it is more correct than "font" (even though "font" is the word used by RMIT and most font download sites).  According to Wikipedia (and who am I to argue?), Caslon is a typeface, while 8-point Caslon Italic is a font, i.e. a font is a specific size, weight and stylistic variant of a font family or typeface.

Media's disingenuous portrayal of Canada's "pandemic early warning system"

There has been much rending of garments and tearing of hair in the media over the demise of Canada's Global Public Health Intelligence Network (GPHIN), which was effectively abandoned in May 2019. An easy scapegoat for Canada's experience of COVID-19 makes just too good a story, but I think its real significance has probably been much overstated.

In fact, it seems like the  network, often described, rather grandly, as our "pandemic early warning system", was established in 2009, but was already starting to be run down and reassigned as early as 2013. In 2009, for example, the network issued 877 alerts (a ridiculous number, and way too many for any government official to keep track of and assess). This had already fallen to 198 by 2013, and just 21 alerts were issued in 2018.

So, this was not a case of the Liberal government making a single bad decision in 2019; it was a fait accompli long before that. And anyway, it turns out that GPHIN itself had, to a large extent, control over its own budget and its priorities, and it was not really, as it is usually portrayed, a dramatic decision of a faceless bureaucrat (or even a Prime Minister) to "pull the plug" on an organization that was at the top of its game, and which could have somehow saved Canada from the COVID pandemic and saved thousands of lives.

There seems to be little evidence that the network ever saved ANY lives, even through outbreaks of SARS, H1N1, Zika and Ebola. In the case of COVID-19, governments around the world were well aware of it in January 2020, but very few considered it to require any action until March. Even then, the virus was not well understood, and most countries were not  giving good, effective advice until much later. GPHIN would not have changed this. If GPHIN had issued an alert in, say, December, would anything have transpired any differently? I don't think so.

In fact, you can probably say the same thing about the UN's investigation of China's early communication about the virus. If China had told the world in December rather than January that there was this unexplained virus it was concerned about in Wuhan, what would actually have changed in the world's reaction to it? (Setting aside the fact that very few people outside of China believe a word that China says these days anyway...) This is also, to a large extent, a more-or-less pointless search for a scapegoat, not so much by the UN, but by many member countries.

And GPHIN? Meh.

Tuesday, February 23, 2021

Investigations into long-term care homes still ongoing ... or not

In the first wave of the COVID-19 outbreak, long-term care homes and  retirement homes were disproportionately hit, particularly in terms of deaths. We all saw those harrowing reports about old people languishing in their own feces as support staff were overwhelmed and sickened. Various investigations and inquests were promised, and many were begun, as doctors warned of an impending second wave of the virus.

Well, the second wave came, and LTC and retirement homes again bore the brunt of infections and deaths. Figures are hard to come by, but there seem to have been been more outbreaks and deaths in senior's homes than during the first wave.

Now, the healthcare professionals are talking about a third wave (before the second is even finished), and we are still no further forward on improving staffing and regulations in long-term care homes. We know how this is going to play out (and, with the spread of various variants of concern, this one may be even worse, vaccinations notwithstanding).

So, it comes as a double slap in the face that an investigation into the Herron group of nursing homes in Quebec has been suspended. A probe into the Residences Herron in Dorval, Quebec, was due to start next week, but now it has been delayed until September(!) It was argued that, if investigators did not agree to a delay, the company would just launch a legal challenge that could delay it even longer. What a ridiculous situation!

It seems like the investigations have no teeth and take forever. Meanwhile, more seniors are likely to die senseless and preventable deaths. Crazy!

Monday, February 22, 2021

Blame for Canada's vaccine rollout problems largely partisan in nature

It's interesting how Canadians are perceiving our undeniably stuttering vaccine rollout, and where the blame is being laid. Because, make no mistake, pretty much everyone wants to blame someone, even though, personally, I don't think it's been that disastrous (sure, more and faster would be nice, but this is a marathon not a sprint, and most of the problems have not been of our own making anyway and will be made up).

A Léger poll for the Institute for Canadian Studies shows that, overall, 39% blame the Liberal government's procurement practices, 33% blame the pharmaceutical manufacturers, 12% blame the USA and Europe, 12% blame a lack of infrastructure, and 4% blame "other" ( which I'm guessing might include Health Canada for not approving new vaccines quickly enough).

But the breakdown of respondents by political affiliation is telling. Among Conservative voters, 55% blame government procurement, 19% pharmaceutical manufacturers, 12% the US and Europe, 11% the lack of infrastructure, and 2% other. Compare this with Liberal voters: 21% blame government procurement, 49% pharmaceutical manufacturers, 15% the US and Europe, 11% the lack of infrastructure, and 3% other. Voters for other parties typically, and perhaps predictably, land somewhere between these two extremes, with he NDP and the Bloc Québécois both leaning more towards blaming the Liberals than the vaccine manufacturers for the non-delivery of promises doses, even though this has been largely out of their hands.

So, it seems to me that this poll is, more than anything else, a poll on how partisan the different political parties are, with the Conservatives finding themselves way out in front in terms of partisanship. It's interesting that the Green Party, whose members I trust to be more thoughtful and objective than most others, are allied much more closely with the Liberals on this, with 36% blaming pharmaceutical manufacturers and just 27% blaming the Liberals' procurement. And the Greens are not doing this out of a desire to protect their chosen party's reputation - they are as critical of the Liberals as any party - so this is probably closer to where the blame should actually lie.

Friday, February 19, 2021

Chinese treatment of Uyghurs: genocide or not genocide?

It has been rather heavy weather listening to Justin Trudeau prevaricate about whether or not the Chinese treatment of their Uyghur (Uighur, Uigur) minority in Xinjiang state amounts to genocide. Granted, the use of the word is not to be taken lightly, as Trudeau points out, but still...

There is no shortage of media reports about what is happening in Xinjiang: mass incarceration in concentration camps ("re-education centres", as China would have it), forced enslavement, torture, mass rapes, disappearances, murders, forced sterilizations and abortions. The list goes on. It certainly looks, and probably smells, like genocide.

This is not just a nice matter of semantics: to be branded as a country guilty of gencide is about as bad as it gets in international relations terms. The UN''s Genocide Convention defines genocide as "acts committed with an intent to destroy, in whole or in part, a national, ethnical, racial or religious group", including killing or causing serious bodily or mental harm to members of the group, deliberately inflicting conditions aimed at destroying the group, imposing measures intended to prevent births within the group, and forcibly transferring children from one group to another.

A Liberal-dominated House of Commons sub-committee concluded back in October 2020, that all of this did indeed constitute genocide as it is understood under the UN Genocide Convention. Former Liberal justice minister and the government's special advisor on Holocaust remembrance and anti-semitism has confirmed more recently that what is happening in Xinjiang meets the test of genocide in his respected opinion.

Most countries have issued statements condemning China's treatment of the Uyghurs (not to mention Tibet, Inner Mongolia and Hong Kong). The exceptions include a group (including Nepal, Pakistan, Sri Lanka, Cambodia, Myanmar, and the Philippines) that is financially beholden to China, and of course Russia, which merely says the direct opposite of anything the West says as a matter of principle, and a group of ex-Soviet states (Belarus, Turkmenistan, Tajikistan) that just parrots whatever Russia says. But only the USA has gone so far as to publicly label it as genocide, both under President Trump and President Biden. 

Canada - like so many other countries that have expressed their outrage at the conditions in Xinjiang, but have fallen short of actually calling it genocide - has yet to do so officially. Now, though, a Conservative motion on the issue will come to a non-binding vote next week. The Conservative, NDP and Green opposition parties have all come out unequivocally in declaring the Chinese practices to amount to genocide, so the vote is sure to succeed. 

Prime Minister Trudeau, though, Is being much more careful in his statements on the matter: "When it comes to the application of the very specific word 'genocide', we simply need to ensure that all the i's are dotted and the t's are crossed in the processes before a determination like that is made... It's a word that is extremely loaded". Many people think that Trudeau is being way too careful with his words, but it's not quite as simple as that.

But it's one thing to make these kinds of declarations as an opposition party and quite another to be the party in power that will be saddled with the responsibility for official decisions made. It is the governing Liberal Party that will have to deal with China, not the Conservatives, safe in opposition. How the government follows up any vote would be an equally fine line, balancing symbolic gains with strategic costs.

And make no mistake, there will be repercussions from China for such a vote. You only have to look at the arrest of Michael Kovrig and Michael Spavor on trumped-up charges 802 days ago in retaliation for Canada's arrest of Huawei executive Meng Wanzhou. China would be quite capable of executing the two Michaels in retaliation for such an international embarrassment as a vote of genocide, or of kidnapping other Canadian citizens. Such an eventuality would be on the heads of the government, and specifically on Justin Trudeau. The economic fallout would also certainly be heavy, although that would be more easily justified.

So, yes, I can say that it is genocide. The opposition parties can say it is genocide. Even the USA can say it is genocide. But can Canada?


The vote on whether or not China is committing genocide in Xinjiang resulted in a resounding "yea", to the tune of 266-0. So, no-one voted against the motion, but a lot of MPs abstained (there are 388 MPs in parliament in total), including Prime Minister Justin Trudeau and the whole of the Liberal cabinet. However, some 70 Liberal MPs did vote for the motion, in a free vote, and arguably this sets an important, and possibly dangerous, precedent, and sends a reasonably unequivocal message to China. This marks the first time a legislative body has declared the Chinese treatment of its Uyghur population to constitute genocide, and so in some respects it goes further than the USA, which has just limited itself to comments and opinions of some major administration figures. UPDATE: Since then, the Dutch parliament has also passed a very similar non-binding motion.

The Canadian vote is non-binding (i.e. just for show), and does not commit Canada to any concrete actions, although the extent of the majority suggests that SOMETHING should be done. Canada's membership of the UN Convention on Genocide means that they cannot just deal with a genocidal country on a business-as-usual basis. A last-minute amendment to the motion calling for the 2022 Winter Olympics to be moved from China was also passed, albeit with a smaller majority. But it remains to be seen what Canada will feel obliged to do in concrete terms. And, of course, what China does in response...

India tries to outdo China and Russia in vaccine diplomacy

Some interesting geopolitical moved are playing out in the area usually referred to as "vaccine diplomacy".

The main players are China and Russia - no surprise there - but also India, which is increasingly active. Both China and Russia are playing economic and political games quite unabashedly, as is their wont, exporting vaccine doses even at the expense of their own populations, while accusing Western countries of hoarding doses for their own populations. This plays very well with developing nations. Crates of Sinopharm vaccines have been arriving in countries like Zimbabwe and Equatorial Guinea marked with stickers blazing "China Aid. For shared Future." Quantities of Russia's Sputnik V vaccine has been shipped to countries like Guinea, Algeria, Tunisia and Togo.

Even Europe has been tempted. Serbia, for example, has snapped up vaccines offered by both Russia and China, rather than wait for the EU to get its act together, as has Hungary. Even worse, Serbia has been offering some of its doses to ethnic Serb populations in Bosnia-Herzegovina and Kosovo, adding a whole ugly ethnic element to vaccine diplomacy.

India, which has a huge vaccine production capacity (indeed, the largest in the world), has, in some ways, gone even further than China and Russia. It is offering vaccines FOR FREE to neighbours ("friendly countries") like Nepal and Sri Lanka, which it worries have increasingly fallen under Chinese sway in recent years, accumulating large amounts of goodwill and soft power in the process. It has also exported large quantities to relatively wealthy countries like Brazil, South Africa and UAE on commercial terms, as well as several poorer countries in Africa, Latin America, the Caribbean and Asia, despite having vaccinated only 1% of its own huge population. Even Canada is trying to import vaccines from India

Both Russia's Sputnik V and, to a lesser extent, China's Sinopharm and Sinovac  vaccines are considered to be both "safe and effective" (even by "Western standards"), so you can well see that if poorer countries are faced with a choice of no vaccines (or maybe vaccines through the UN-sponsored COVAX program at some unspecified time in the future) or vaccines naow from China or Russia, they might choose the latter.

Facebook blocks news feeds in Australia, but that's OK

Kudos to Australia for sticking to their guns and insisting that Facebook pay for the Australian press news stories they feature in their news feeds, despite threats from Zuckerberg & Co that it would block news-sharing on its platform in Australia.

Well, Facebook has made good on its threats, but that's not necessarily a bad thing. Facebook users are the ultimate in lazy surfers, content to suck up whatever Facebook's algorithms throw at them, happy in their little confirmation bias bubble. And much of this is fake news, as we well know from four years of Trump rule. Now, if they want news, they have to go look for the source, not just whatever skewed angles Facebook pushes at them, maybe subscribe to local media companies, and be subjected to local news compamies' advertisements, not Facebook's.

Interestingly, Google, when faced with the same ultimatum from Australia, caved, and has struck deals with Australian publishers for the use of their news stories. Which, it seems to me, is the right thing to do, morally. Google 1, Facebook 0.

Other countries are taking note of all this, including Canada, which issued a stern rebuke to Facebook. Canadian Heritage Minister Steven Guilbeault: "I must condemn what Facebook is doing. I think what Facebook is doing in Australia is highly irresponsible and compromises the safety of many Australian people." Guilbeault has recently met with counterparts from Australia, Finland, France, and Germany to discuss a common front on dealing with the mews policies of Facebook, Google and others.

Surely, a company full of supposedly bright young things can figure this out (Google did). Paying for what they use will not bankrupt Facebook. Many media publishers, on the other hand, could well find themselves out of business in the next few years unless something changes.


As could have been expected, after days of outraged bluster and vocal recriminations, Facebook quietly caved, and agreed to pay Australian news outlets for their content

Not content with an anticlimactic, and possibly negatively-perceived, news report, they even pledged to invest over $1 billion in the news industry over the next few years. They will probably need it, as other countries follow Australia, realizing that -imagine! - they too can get paid for what they produce.

New head of WTO definitely not an old white guy

Quick shout-out to Nigeria's Ngozi Okonjo-Iweala on her appointment as head of the World Trade Organization (WTO) this week (now that Donald Trump is no longer around to block new WTO appointments).

The WTO, and international trade in general, must be the ultimate bastion of the old white guy network. Ms. Okonjo-Iweala is none is things.

And may she keep rocking those dramatic  dresses!

Wednesday, February 17, 2021

Texas blackouts turn out to have been caused by gas plants, not wind turbines

The big freeze in Texas this week and the associated electricity blackouts, have led to some typical Republican false news. 

Several right-wing news outlets and the social media accounts of various Republican senators have been laying the blame for the blackouts squarely at the door of the state substantial wind energy sector. Because, for reasons I have never understood, Republicans (and conservatives in general) have a reflexive hatred of renewable energy, and a reflexive (and equally inexplicable) love of anything to do with oil, gas and coal.

Unfortunately for this narrative, although a few wind turbines did in fact ice up, the main underlying cause of Texas' blackouts was the state's gas power stations. Per the Electricity Reliability Council of Texas (ERCOT), which is the body responsible for overseeing energy production in the state and mixing and maintaining  its various sources: "It appears that a lot of the generation that has gone offline today has been primarily due to issues on the natural gas system". In a deregulated, profit-driven power system, the gas power stations in particular were woefully unprepared for temperature extremes. That, and the fact that Texas' grid has no links with other states that might be able to help out in this kind of eventuality.

And those pictures of helicopters de-icing wind turbine blades that have been making the rounds of conservative social media? They turned out to be from northern Sweden in 2014, not Texas in 2021 as billed! Oops. These days, wind turbines seem to work perfectly well in winter in Sweden, Canada, even in Antarctica. 

But I wonder why right-wingers have this innate suspicion any fear of renewables? And, equally, why do they all seem to support moribund industries like oil and coal? Is it just that they feel it incumbent on conservatives to protect the past and old things in general, and to be dismissive and mistrustful of anything new (relatively speaking)? It's a mystery to me.

Monday, February 15, 2021

Repeated ads work, so get used to them

If, like me, you hate - I mean HATE - that tedious, dated Rolex advertisement they insist on playing ad infinitum during every major televised tennis tournament you've ever seen in the last several years, you might have wondered, like me, whether it might not be counter-productive for advertisers to repeat ads quite so often.

Apparently, it has been shown that an ad needs to be seen 3.7 times before it "takes", or before a viewer "gets" it. It can then be seen up to 15 times with continuing good results, and after 15 "impressions", it ceases to be effective. But that doesn't means that it starts to actually have a negative effect, just that it does not further consolidate the favourable effects.

At no point, then, does repeating an ad seem to actually work against the advertiser. Many times, I have said things like, "If they show that ad again, I swear I will never buy x ever again". But apparently I don't mean that, and the old adage "there's no such thing as bad publicity" (a phrase originally attributed to showman P.T. Barnum), really does work in advertising - if not necessarily in politics - unless, of course, the publicity is so egregious and offensive as to be career-ending. Advertisers just want to get their name into your skull any way they can, even if only because of how much you hate it or how much it bores you.

So, sorry, there's likely to be no let-up from those annoying ads. They work. Anyway, why make five different ads when you can just make one and have the same effect. And advertisers wonder why people hate them.

Canada clamps down on border travel, but truck drivers still have a free pass

As of today, new rules belatedly come into force requiring a negative PCR COVID-19 test for anyone travelling by land from the USA to Canada (or a positive test taken 14 to 90 days earlier, which I'm less convinced about), to be followed by a mandatory 14 day pre-arranged quarantine period. Although Canadian citizens cannot be turned away at the border (unlike US and other citizens), they can nevertheless be fined $3,000 if they don't have the required paperwork.

From next week onwards, the requirements will be further ramped up, and arrivals will also be required to take a molecular test on arrival at the Canadian border, followed by a mandatory 3-day hotel stay at the border while the test is being processed (rules that are similar to those recently instituted for travellers arriving by plane).

This is all well and good - it's no coincidence that the countries that have dealt best with the pandemic have been mainly island countries, like Australia, New Zealand and Taiwan, that can more easily regulate their arriving travellers - but bear in mind that this only applies to "non-essential" visits to the country. 

CTV estimates that 93% of arrivals at the Canadian borders will be totally unaffected by the new rules, because healthcare workers and truck drivers (whatever they may be carrying) are considered "essential". So, a truck driver who may have travelled through 14 different states, picked up goods from suspect warehouses and food processing terminals, eaten at greasy spoon truck stops, and slept who knows where, can continue to just wander into the country and potentially proceed to infect any number of locals with complete impunity. 

All the hoopla about the new federal rules? Not such a big deal after all, then. Trucking associations and unions have been agitating for weeks to be exempted from any rule changes. They argue that truck drivers are ultra-cautious and rarely, if ever, leave the safety of their cabs, an argument that sounds pretty unconvincing to me, but then what do I know?

At the same time, Canadian provinces apparently have literally millions of unused rapid testing kits just sitting around. Why on earth would we not be insisting that truck drivers be tested before they enter the country? It may not be 100% reliable, but it's 100% better than no testing at all.

Stop the Steal! Oh, wait, this is Newfoundland!

As an outbreak of variant-laced COVID cases hits Newfoundland and Labrador, which has thus far largely managed to avoid the pandemix crisis that is laying the rest of the country low, the province has had to pivot on a dime to allow for all-mail-in voting in the provincial election, and to extend the deadlnes to accommodate the changes.

I was waiting for anguished cries of "Stop the Steal! Stop the Steal!",  until I realized, wait, this is Canada! There has been no outcry, no recriminations. There is absolutely no expectation of wholesale fraud. People are just getting on with it as best they can't. How different we are from the Americans!

Orphan oil wells should not exist

The province of Alberta alone has some 90,000 inactive oil wells (mothballed due to being no longer economic), and around 3,000 of these are so-called "orphan" wells (defined as a well "that does not have any legally responsible and/or financially able party to conduct abandonment or reclamation responsibilities").

Last year, the federal government ploughed $1 billion - a huge amount of money - into a program to clean up and/or repurpose those sites. Which maybe sounds like a good thing. But my question is why is so much tax-payers' money being pumped in to rectify a problem that is more properly the responsibility of the wealthy oil companies that created the wells in the first place?

Supposedly, the principle of "polluter pays" is already in force. Companies developing oil wells are supposed to be on the hook for reclamation liability for 25 years, after which time it becomes a federal responsibility, meaning that the oil companies are supposed to return an abandoned site "as close as possible to a state that's equivalent to before it was disturbed". But clearly they are not doing that, either going out of business, or just not attending to their responsibilities until their 25-year period expires, at which point they can legally just walk away.

Which is a rather ridiculous situation. Laws should be brought in to force them to attend to reclamation straight away, and not saddle tax-payers with their dirty work. This is just another example of the hidden subsidies that allow oil and gas companies to thrive.

Saturday, February 13, 2021

Burkina Faso's unnoticed humanitarian crisis

Burkina Faso has been going through a humanitarian crisis for over five years now, and this is the first I have heard about it.

The small West African country is one of the world's poorest, finding itself in the bottom twenty by GDP by most measures. The current sectarian violence is happening at the hands of unspecified (at least in this article) "extremists". Most of the reports I have found seem to go out of their way to avoid using the word "Muslim" - I guess that's politically incorrect these days - although an MSF report does manage to describe the extremists as "jihadis", which is a bit of a give-away. So yes, sorry, this is another religious war.

At any rate, this is one of the world's fastest-growing displacement and refugee crises, with more than a million people displaced from their homes. An estimated 3.5 million of the country's 20 million inhabitants are in dire need of assistance, and more than 2,000 people have been killed in the last year alone.

You read about Yemen, Syria, Libya, Myanmar, and any number of other sad cases. This, I think, is the first time I have seen Burkina Faso mentioned in the news EVER, for any reason at all.

Trump acquitted, again

Sad, but true. Donald Trump has been acquitted in his second impeachment trial.

The vote was 57-43, so seven Republican senators also votes with the Democrats to convict Trump of inciting the January 6th riots in Washingon DC. But it was still along way from the 67 (a two-thirds super-majority) needed for a conviction, which also means that Trump wasn't able to be banned from standing for president in the future.

Shout out to Republican Senators Richard Burr (North Carolina), Bill Cassidy (Louisiana), Susan Collins (Maine), Lisa Murkowski (Alaska), Ben Sasse, (Nebraska) Mitt Romney (Utah) and Pat Toomey (Pennsylvania) for voting with their consciences. Shame on all the others for not having the guts or the gumption to do the right thing.

Britain's worst economic crash for 300 years - wait, what?

I've read a few times recently that, in 2020, Britain suffered its worst economic crash for three hundred years. Now, everybody knows what happened in 2020 - it has affected the rest of the world too - but what the hell happened in 1709 that was so bad?

Well, apparently it was The Great Frost, which mainly affected Britain and France, but presumably also various other countries nearby. All of Europe at that time was in the grip of the Little Ice Age - you've probably seen pictures of people skating on the River Thames - and the winter of 1709 was the single worst year, the coldest European winter in the last 500 years, to the extent that crops failed to an unprecedented degree.

It's difficult to believe that a bit of bad weather was enough to set the country back more than the Great Depression of the '30s (although Britain was much less affected than the US), the 2008 recession, more than even than the COVID-19 lockdown. But bear in mind that, in 1709, Britain (and the rest of the world, for that matter) was a pre-industrial, pre-globalization, agrarian economy, so any hit to crop harvests was all but catastrophic.

With a third wave looming, Canadian provinces stick to the same tired old script

Here we are, déjà vu all over again.

As the second wave of COVID-19 starts to sputter here in Ontario and Canada as a whole (but is by no means over), the premiers start to open things up economically, laying the groundwork for a new and potentially even more brutal third wave. 

The same thing happened in the summer: cases came down pretty low, and all of a sudden restaurants were open, malls were packed, and hairdressers and nail salons were doing brisk business, all directly against the express advice of a plurality of health advisiers and experts. Unlike Australia, New Zealand, Taiwan, Vietnam and others, which kept strong restrictions and travel bans in place until the numbers of new cases reached ZERO (as long ago as May 2020!), Canada left a simmering number of infections to regroup and build up until a second (and worse) wave very quickly established itself.

Well, despite strident warnings, it's going to happen all over again. Ontario, Quebec, Manitoba and Alberta are all opening up, and plan to open up much further in short order. Yes, cases are still on a general downward trajectory across most of the country, although there is a still ober 3,000 cases a day, a third of them in Ontario. Meanwhile, the new variants (no longer so new - we know all about them) from the UK, South Africa and Brazil are already here and ready to run rampart. Newfoundland, which has done pretty good job thus far of keeping a lid on the spread of the virus, is in full panic mode, as the new variants spread faster than anyone could have imagined. And it's coming to a mall near you!

The medical establishmemt is doing its best to warn against unfettered liberalization, now of all times, using language like, "we're playing chicken with COVID", "opening indoor dining is a mistake, plain and simple", "the prudent thing to do would be to go slow and see what happens after a few weeks", "this is not the time to really begin pulling back on restrictions", etc, etc.

I understand that the premiers have to weigh lockdowns with mental health considerations and the health of the economy (and the latter seems to be more top of mind for most conservative premiers). But the bottom line is that, if we open up now, a third wave will break upon us, before the second is even over, complete with full lockdown and even more severe restrictions than we have now. And then how will the economy be looking?

Thursday, February 11, 2021

The world's biodoversity hotspots

I like maps. Here's a nice map, courtesy of Conservation International, which shows how the world's biodiversity hotspots, making up just 2.4% of the earth's landmass, supports about 50% of the world's plant species and 42% of all known vertibrate species. 

In terms of threatened wildlife, these relatively small areas areeven more important, providing a home to 79% of threatened amphibians, 63% of threatened birds, and 60% of threatened mammals.

There are a few (to me) unexpected areas within these special places, including the Mediterranean, the mountains of Russia, the Horn of Africa, and the Caribbean.

The other thing a map like this brings home: all the conservation work we do here in Canada is going to have little or no impact on world biodiversity. But, hey, we do what we can in our own 'hood.

How is drug decriminalization actually supposed to help?

The province of British Columbia is looking to become the first province in Canada to decriminalize drugs. Not just cannabis, which has been legalized (not just decriminalized) for over a year now in Canada, but ALL drugs, including heroin, cocaine and all the rest. The province needs the permission of the federal government to do so, and the two are in negotiations as we speak.

Just to be clear, decriminalization usually refers to the conplete removal of criminal penalties for drug use and possession, and is not to be confused with legalization, which completely removes all legal detriments to a previosuly illegal practice. Thus, under decriminalization, the practice remains technically illegal, but the punishment is drastically reduced or removed. Defelonization is another related term, meaning that drug possession penalties are reduced from the level of a felony to a misdemeanour, and is therefore a less drastic step than decriminalization.

The decriminalization lobby is strong, and highly committed to the probity and effectiveness of its position. But how exactly is decriminalization supposed to help?

Organizations like the Drug Policy Alliance lay it out for us. Decriminalization would usually seek to eliminate criminal penalties for drug use and possession (at least as regards "small quantities", however that might be defined), as well as the possession of drug equipment like syringes, and to eliminate penalties for small-scale low-level selling of drugs. It supporters claim that such a policy change would reduced jail populations and costs, and free up law enforcement resources and allow them to concentrate on more appropriate activities. 

But it would also, proponents argue, prioritize health and safety over punishmemt for drug users and, crucially in my opinion, reduce the stigma associated with drug use. This, it us argued, would encourage drug users to come foward and seek treatment and other supports, and to remove barriers to evidence-based harm-reduction practices like drug-checking and heroin-assisted treatment.

Now, to me, you don't bring in this kind of radical policy just to save law enforcement costs - we could save lots more by completely abandoning our police forces, although I know there is a contingent who would happily do just that! But if it is actually true that addiction and harm reduction programs can be substantially aided, then that might well be a good reason to go down that route. 

BC would not be the first jurisdiction to try it, so some hard evidence is already available. The usually-quoted example is Portugal, which decriminalized drug possession as long ago as 2001. In the Portuguese case, decriminalization did not result in an explosion in drug use, which remains below the European average and well below US levels. More importantly, though, there has been a 60% increase in drug users pursuing treatments, the number of new HIV cases has fallen dramatically, and drug overdose fatalities fell by 80% over 14 years. Oh, and court cases and incarcerations for drug offence also fell dramatically, as might be expected.

So, from this analysis at any rate, decriminalization does seem to actually work, and does not seem to have have any unfortunate side-effects.

Wednesday, February 10, 2021

Trump impeachment trial proceeding at and Entian pace

The Trump impeachment trial - supposedly an expedited version of the long, drawn-out first impeachment trial of a year ago - has begun in Washington DC.

But all they've succeeded in achieving so far is to agree that the trial can in fact go ahead.

It put me in mind of a scene in The Lord of the Rings, when the Ents call a special high-level meeting and, after hours and hours of debate, they finally manage to agree that the two Hobbits are in fact Hobbits. Merry and Pippin can't believe that, after all that time, the main matter that brought the Ents together has not even been touched on.

The five doses/six doses débacle

This whole discussion of whether five or six doses can be extracted from each vial of Pfizer vaccine just boggles my mind.

The latest I have read is that Japan, which will start its vaccination program next week (and we think OUR vaccine roll-out has been slow here in Canada!), admits that it will end up throwing out millions of  the 144 million Pfizer doses it has ordered, just because it does not have anything like enough of the special "low dead space" syringes it need to squeeze out that final sixth dose.

Canada has recently come down on six doses per Pfizer vial, and is investing in more of the specialty syringes (which - go figure! - are now in short supply) in order to achieve that, thinking to squeeze more vaccine out of the available reduced supply from the company. But Pfizer has just turned round and said, well, in that case, we'll just send you fewer vials because the contract was for doses, not vials. The cheek!

In fact, in theory, it should be possible to get SEVEN doses out of the liquid in each vial, but no-one has figured out how to do that in practice. And anyway, it seems like there would be no point in trying...

Many questions spring to mind. Why is this only an issue with the Pfizer vaccine (or maybe it's not)? Could Pfizer really not arrange for six doses to be accessible to everyone, regardless of the syringes they happen to have? Did they know this was going to happen and just didn't bother to mention it (they have been selling the vials marked as containing 5 doses, but most countries were ordering syringes several months ago so this issue could have been pre-empted)? Does Pfizer also happen to sell the special syringes needed? 

People were suspicious and mistrustful of big pharma companies before the vaccine débacle. They are even more so now.

Tuesday, February 09, 2021

Starchitect engages in flights of BS

Architects don't half talk a load of crap. So do lots of artistic types, I know, but I've noticed in the past that architects are particularly prone to flights of BS.

Take, for example, the 91-year old Toronto native starchitect Frank Gehry, who has designed (at least in the back-of-an-envelope respect) a couple of new tower blocks for King Steeet West.

They are vaguely interesting tonthe extent that some sections are cantilevered and twisted somewhat, but essentially they are blue glass and steel monoliths such as comprise much of the rest of Toronto's downtown core, albeit in a part of downtown not yet totally dominated by blue glass and steel monoliths.

So, what does the great man find to tell the press about it? "I think the buildings have a level of humanity other buildings around them don't have," (er, nope, not really!), "and a respect for local surroundings" (er, definitely not!) King Street still has a fair few two-storey older buildings in its streetscape, which could be said to exhibit some degree of "humanity" and "respect", but these new planned edifices are just blue glass and steel monoliths - more interesting than some, not as interesting a others - so, please, don't talk to me about "humanity" and "respect"!

Gehry continues: "The idea was that the towers would speak to each other. And I wondered, could you create a void between the two that was strong enough to suggest a third building?" Wha'? They're just buildings, dude, separated by a space from one another, as building tend to be. Can you not just let them stand (or not) on their own merits, without lapsing into deep BS-isms?

Bubbles on top of bubbles

Massively overpriced Tesla has just thrown  $1.5 billion into purchasing the massively overpriced cryptocurrency bitcoin, in a classic example of one bubble huffing and puffing to blow up another bubble.

Well, when I say classic, that's probably not quite the right term, given that this has probably never happened before, at least not in this way.

Tesla has been recognized as dangerously overvalued for some time now, having surged five-fold over the last year or so. Per JP Morgan in December 2020: "Tesla shares are in our view and by virtually every conventional metric not only overvalued, but dramatically so". Clear enough?

I haven't written about bitcoin for some time now, but since that time it has also surged about five-fold and is considered dangerously overvalued. People seem to have pretty much given up on bitcoin ever operating as a serious financial instrument, and are just treating it as a game at this point.

So, Tesla deciding to buy into bitcoin instead of paying off some if its $11 billion in debt is a bizarro move by Tesla's ever-bizarro leader Elon Musk. You can look on it as predictably unexpected. But you would think that the stock exchange would throw up its metaphorical hands in horror, no? Instead, what actually happened? Tesla's share price went UP, and investors appear to be perfectly OK with the world's most overpriced company piling into the world's most volatile speculative investment.

Call me old-fashioned, but it all makes me very glad our savings are tied up in boring old blue-chip stocks.

Monday, February 08, 2021

Why we cross our legs

Ever wonder why people cross their legs? No, me neither. Until today, that is. Whether it's ankle-on-ankle with straight legs, the "figure-four" (ankle on opposite knee), or "European-style" (the classic one knee on top of the other), it seems to be almost universal.

Well, it turns out that, despite some claims to the contrary, we don't really know. One website purports to explain that we cross our legs in an attempt to "improve the mechanics of the lower back and take the strain off'. Which kind of makes sense, except that ... the same article later mentions that crossing your legs is "horrible for your posture", "puts undue pressure on your peroneal nerve", "can also stretch out your piriformis", and "can cause your BP to spike by more than 6 percent". Also, "keeping your legs crossed while sitting can purportedly cause varicose, or 'spider', veins".

Another rather unconvincing explanation offered is that crossing one's legs is a "power move", giving the example of various US presidents who cross their legs. But, surely a plurality of people - male and female, powerful and defenceless - cross their legs, not just presidents. And in what way is crossing the legs intimidating? Surely, "manspreading" is much more aggressive and macho.

Another website looks at the issue from a more psychological/sociological point of view and, like so many psychological/sociological explanations, it is equally wooly and unconvincing. Maybe the person is being submissive or anxious or repressed or who knows what. Well, yeah, maybe. But that still doesn't explain why pretty much everyone does it

Slightly more convincing, although far from a revolutionary thought, is the idea that it is just a learned behaviour. We cross our legs because our parents and our siblings and our work-mates cross theirs. Women in particular are "taught' to cross their legs because it is considered polite and elegant and demure. 

So, sorry, no fascinating insights to offer. We cross our legs because ... we cross our legs.

Sunday, February 07, 2021

Some things you may not have thought about regarding vaccine trials

Here's an interesting and thought-provoking article by someone who volunteered for the British clinical trials for the Oxford/AstaZeneca COVID vaccine.

As well as giving an insight into the actual process of a double-blind placebo trial, it also looks at the decision-making behind volunteering for such a trial: you might get an early dose of a working vaccine - and make a few hundred bucks - or you might get the placebo and remain unprotected, long after other people have been receiving doses of a perfectly good working vaccine.

It looks at some of the more philosophical and ethical factors involved, as well as some of the pactical considerations, in something that we think of as a purely scientific process. It also considers the implications of the need to continue monitoring trial subjects long-term, and the difficulties that vaccine producers are encountering in continued testing of their products at a time when many people, particularly older people, have either already been vaccinated or at least are expecting to be called up any day now.

When I read about healthcare workers hesitating to get the COVID vaccine because "they feel like they're being treated as guinea pigs", I now think about this article, and the army of volunteer guinea pigs like her who put their time and potentially their health on the line to test out these drugs for the rest of us. What a slap in the face it must be for the actual trial subjects to read about this kind of spurious concern, particularly among healthcare workers who should know better. 

Britain has a "Jenner moment" and gets away with it

If you remember your science history, British physician Edward Jenner revolutionized medicine at the end of the 18th century, when he inoculated an eight-year old boy and then directly exposed him to the smallpox virus. Thankfully for Jenner and the eight-year old boy (and for generations since), the boy survived, and the smallpox vaccine was born. But, in the process, Jenner became the poster boy for unethical medicine.

The British medical establishment came close to revisiting this unfortunate precedent recently when it decided, in its wisdom, that it was perfectly OK to wait as long as 12 weeks for the second dose of the COVID-19 vaccine, despite clear guidance from the vaccine manufacturers that the second dose should be administered three or four weeks after the first (depending on the particular vaccines).

There was some evidence (although not particularly strong evidence) that it is OK to give the second dose up to six weeks after the first, but no evidence that it was safe to wait any longer than that. The Brits, however, decided to throw caution to the wind and wait 12 weeks by default, and their percentage of population vaccinated looks appropriately rosy as a result. But this was sheer guesswork and not supported by science.

Well, as it turns out, the figures seem to be indicating that, for the AstraZeneca vaccine at least, which is the most commonly administered COVID vaccine in the UK, those who received a second dose 12 weeks after the first are actually even better-protected than those who recieved a second dose up to six weeks later. So, more by luck than judgement, the British health authorities have dodged a bullet and happened on an important virus management finding. It should be noted that there is no such finding (as yet) concerning delaying the second doses of other vaccines like Pfizer or Moderna.

I imagine, though, that the British health officials concerned are breathing a ragged sigh of relief, rather than celebrating a major scientific breakthrough.

Saturday, February 06, 2021

A billion years of continental drift: the movie

Well, this is fascinating, I think.

The journal Earth Science Reviews has published an animated simulation of the last billion years of tectonic movements of the earth's landmasses. Don't ask me how they can do that, but it's done and it seems to be science.

It's interesting to me that at no point is there an obvious "Pangaea moment" when all the continents as we know them today were clustered together and attached as one super-continent. Pangaea is supposed to have existed from 335 million years ago until 175 mlion years ago. This simulation does show various islands clustered around that time, and many of the islands are at least peripherally attached to each other, with narrow connecting bridges and isthmuses. But this is not the huge, wide block of land I usually envisage.

Also interesting: for much of the time, most of the earth's land masses were clustered around the south pole, with most of the globe just one vast ocean.

Friday, February 05, 2021

The Mirror & The Light is Hilary Mantel's apotheosis

I have finally got around to reading the last of Hilary Mantel's excellent Thomas Cromwell trilogy, and The Mirror & The Light is every bit as good as Wolf Hall and Bring Up The Bodies, and then some.

The quality of the writing is astonishing, and she somehow contrives to keep it up for nearly 900 pages. This would normally be long enough to intimidate me into avoiding it completely - I read so slowly and painstakingly - but I have settled into this particular tome, luxuriating and glorying in its class and its transcendence. 

Characters from the previous books continue to develop, in all their complexity, wit and malice, and several new ones are introduced. It is sometimes hard to keep track of the myriad personalities at play, especially given the various titles and nicknames they employ, although there is a handy-dandy guide at the beginning of the book.

Ms. Mantel's language, both in the more descriptive passages and in the dialogue, seems quite modern and familiar, and yet she is also employing some ancient vocabulary and phrasing, little used in this day and age, that makes it seem convincingly medieval at the same time. Sometimes poetic, sometimes salty, sometimes deadpan I don't know quite how an educated Tudor would have spoken, and I don't really care, but this hybrid of her own devising is a wonderful compromise. It is full of courtly elegance, but immediately comprehensible and even contemporary, like a too-perfumed courtesan masking the rank odours of too few baths (my own contribution to the genre). It is quite a feat and, in my view, quite a triumph. 

Just a few little snippets, almost at random:

About his neck is a heavy gold chain, where the emblems of the Howards alternate with the Tudor rose. Under his shirt, in a filigree case, he wears the relics of saints, faded hairs and splinters of bone; on his sword hand, a stout gold band, set with a greyish diamond like a chipped tooth.

'Why would he do it now, when the sentence is already passed, his proven offences so rank that the most merciful prince who ever reigned would not remit his punishment. For I should think that if he were to be excused the penalty, the common people would stone him in the street; or failing that, God would strike him down.' 'And we should spare God the trouble,' Richard said. 'He has much to do.'

We will dress the city for Jane. At every corner a paradise, with a maiden seated in a rose arbour, the roses being striped, argent, vermilion, a serpent coiled about the apple tree, and singing birds, trapped by Adam, hanging in cages from the bough.

'I do not understand you, Cremuel. You are not afraid, when you should be afraid. You are like someone who has loaded the dice.' 'Loaded the dice?' He says. 'Is that what people do?'

Christophe's head declines from view, a greasy planet in a crooked cap.

The very swans on the river stunned with heat, the trees drooping, the hounds from the courtyard making their hound music, till their bell-like voices withdrew into the distance, and the train of gallant horsemen moved away over the meadows, and the queen knelt praying in the afternoon light, and the king who went hunting never came back.

She is quite simply the best historical fiction author writing today. Only 750 pages still to go. Bring it on!

Thursday, February 04, 2021

Canada's domestic vaccine production finally shows some promise, just not soon

And while we are on the subject of vaccines - and what other subject is there right now? - the Liberal government is making a big deal of the news that Canada is to have its own production facilities in Montreal to manufacture the Novavax vaccine, belatedly securing a domestic COVID-19 vaccines. even as our imports of pre-ordered vaccines grind to a halt and recriminations on all sides abound.

Minor caveat: the Novavax vaccine is not yet approved for use in Canada, and the National Research Council-owned facility (not even fully built yet!) will not be churning out doses until the end of the year at the earliest, well after the government's September deadline for all Canadians to be vaccinated. The building work is expected to be complete by the summer, but approvals and certifications and paperwork could well take several months more. Ultimately, the facility is expected to be able to produce up to 2 million doses a month.

Too little, too late, as opposition politicians assert? Maybe, but I have a suspicion that we may well be still looking for vaccine doses by that time. And then, of course, there's always the next pandemic, and the next...

What I don't really understand is why this idea of licencing production facilities was not thought about a year ago? Well, arguably, it was, and the Montreal facility was originally being built for the ill-fated CanSino vaccine, and it ran afoul of "good manufacturing practices" requirements, and encountered delay after delay.

As for the other vaccine manufacturers, Procurement Minister Anita Anand has confirmed that the government did in fact strenuously and repeatedly raise the issue of domestic manufacture, and all of them refused to allow Canada to manufacture their products here under license, due to the state of our "biomanufacturing capability".

As usual, Canada is being compared (unfavourably) with Australia, which has an agreement to produce the AstraZeneca vaccine, starting sometime this spring (as has Japan). Canada apparently passed on domestic manufacturing rights for the AstraZeneca product. But, hey, Australia has hardly even started vaccinations. Not that they really need it, with six new cases a day to deal with!

Canada embarrasses itself by plundering its COVAX contribution

Canada's COVID-19 vaccine rollout is not, it has to be said, going particularly well, although it's not going as disastrously as opposition politicians would have you think, and it's mainly the fault of the vaccine manufacturers rather than anything our various governments are doing wrong.

That said, the latest news has me shaking my head. Canada signed up with the WHO-sponsored COVAX program last September, and this seemed like a good and worthy thing to do. The program pools funds from wealthy countries to help buy vaccines for 92 low- and middle-income countries that can't afford to buy for themselves. However, the program also allows countries to dip into the funds for themselves - why? I have no idea - and Canada has decided in its wisdom that it needs to do just that. 

So, Canada, a G7 country, is to take 1.9 million doses of AstraZeneca vaccine out of its COVAX pledge (when we finally get around to approving that vaccine, that is), despite having already ordered 20 million doses of that vaccine through regular commercial channels, and having ordered enough doses from seven different conpanies to vaccinate the entire population at least four times over.

That's 1.9 million doses that will not therefore be available to poor developing countries in Africa, Asia and South America.  A spokesperson for the International Development Ministry explained, "Our contribution to the global mechanism has always been intended to access vaccine doses for Canadians as well as to support lower-income countries" - as though that makes things any better!

From the other point of view, a spokesperson for Gavi, the vaccine alliance that is coordinating the COVAX program, explained, "Does it help when countries that have a lot of bilateral deals don't take doses? Of course it helps, because then there are more doses available for others". Clearly, Gavi was not anticipating "donor" countries taking doses for themselves out of the scheme, even if there is the facility to do that. And these doses are not goong to arrive anytime soon, so they are not going to help Canada's current vaccine crunch.

Canada is not the only rich country to exercise its options under the scheme - New Zealand and Singapore are also on that list - but it is the largest and richest. It's a mite embarrassing.

Hospital masks policy makes no sense

Does anybody know why, when I visit a hospital for an appointment, they insist that I take off my snug-fitting, double cloth masks (four layers), and put on their flimsy, ill-fitting, single-layer, blue "medical" mask?

Makes no sense to me.