America’s Obesity Epidemic Threatens Effectiveness of Any COVID Vaccine

By Sarah Varney, Kaiser Health News August 6, 2020; Photos: Chokniti Khongchum

For a world crippled by the coronavirus, salvation hinges on a vaccine.

But in the United States, where at least 4.6 million people have been infected and nearly 155,000 have died, the promise of that vaccine is hampered by a vexing epidemic that long preceded COVID-19: obesity.

Scientists know that vaccines engineered to protect the public from influenza, hepatitis B, tetanus and rabies can be less effective in obese adults than in the general population, leaving them more vulnerable to infection and illness. There is little reason to believe, obesity researchers say, that COVID-19 vaccines will be any different.

“Will we have a COVID vaccine next year tailored to the obese? No way,” said Raz Shaikh, an associate professor of nutrition at the University of North Carolina-Chapel Hill.

“Will it still work in the obese? Our prediction is no.”

More than 107 million American adults are obese, and their ability to return safely to work, care for their families and resume daily life could be curtailed if the coronavirus vaccine delivers weak immunity for them.

In March, still early in the global pandemic, a little-noticed study from China found that heavier Chinese patients afflicted with COVID-19 were more likely to die than leaner ones, suggesting a perilous future awaited the U.S., whose population is among the heaviest in the world.

And then that future arrived.

As intensive care units in New York, New Jersey and elsewhere filled with patients, the federal Centers for Disease Control and Prevention warned that obese people with a body mass index of 40 or more — known as morbid obesity or about 100 pounds overweight — were among the groups at highest risk of becoming severely ill with COVID-19. About 9% of American adults are in that category.

As weeks passed and a clearer picture of who was being hospitalized came into focus, federal health officials expanded their warning to include people with a body mass index of 30 or more. That vastly expanded the ranks of those considered vulnerable to the most severe cases of infection, to 42.4% of American adults.

Obesity has long been known to be a significant risk factor for death from cardiovascular disease and cancer. But scientists in the emerging field of immunometabolism are finding obesity also interferes with the body’s immune response, putting obese people at greater risk of infection from pathogens such as influenza and the novel coronavirus. In the case of influenza, obesity has emerged as a factor making it more difficult to vaccinate adults against infection. The question is whether that will hold true for COVID-19.

A healthy immune system turns inflammation on and off as needed, calling on white blood cells and sending out proteins to fight infection. Vaccines harness that inflammatory response. But blood tests show that obese people and people with related metabolic risk factors such as high blood pressure and elevated blood sugar levels experience a state of chronic mild inflammation; the inflammation turns on and stays on.

Adipose tissue — or fat — in the belly, the liver and other organs is not inert; it contains specialized cells that send out molecules, like the hormone leptin, that scientists suspect induces this chronic state of inflammation. While the exact biological mechanisms are still being investigated, chronic inflammation seems to interfere with the immune response to vaccines, possibly subjecting obese people to preventable illnesses even after vaccination.

An effective vaccine fuels a controlled burn inside the body, searing into cellular memory a mock invasion that never truly happened.

Evidence that obese people have a blunted response to common vaccines was first observed in 1985 when obese hospital employees who received the hepatitis B vaccine showed a significant decline in protection 11 months later that was not observed in non-obese employees. The finding was replicated in a follow-up study that used longer needles to ensure the vaccine was injected into muscle and not fat.

Researchers found similar problems with the hepatitis A vaccine, and other studies have found significant declines in the antibody protection induced by tetanus and rabies vaccines in obese people.

“Obesity is a serious global problem, and the suboptimal vaccine-induced immune responses observed in the obese population cannot be ignored,” pleaded researchers from the Mayo Clinic’s Vaccine Research Group in a 2015 study published in the journal Vaccine.

Vaccines also are known to be less effective in older adults, which is why those 65 and older receive a supercharged annual influenza vaccine that contains far more flu virus antigens to help juice up their immune response.

By contrast, the diminished protection of the obese population — both adults and children — has been largely ignored.

“I’m not entirely sure why vaccine efficacy in this population hasn’t been more well reported,” said Catherine Andersen, an assistant professor of biology at Fairfield University who studies obesity and metabolic diseases. “It’s a missed opportunity for greater public health intervention.”

In 2017, scientists at UNC-Chapel Hill provided a critical clue about the limitations of the influenza vaccine. In a paper published in the International Journal of Obesity, they showed for the first time that vaccinated obese adults were twice as likely as adults of a healthy weight to develop influenza or flu-like illness.

Curiously, they found that adults with obesity did produce a protective level of antibodies to the influenza vaccine, but they still responded poorly.

“That was the mystery,” said Chad Petit, an influenza virologist at the University of Alabama.

One hypothesis, Petit said, is that obesity may trigger a metabolic dysregulation of T cells, white blood cells critical to the immune response. “It’s not insurmountable,” said Petit, who is researching COVID-19 in obese patients. “We can design better vaccines that might overcome this discrepancy.”

Historically, people with high BMIs often have been excluded from drug trials because they frequently have related chronic conditions that might mask the results. The clinical trials underway to test the safety and efficacy of a coronavirus vaccine do not have a BMI exclusion and will include people with obesity, said Dr. Larry Corey, of the Fred Hutchinson Cancer Research Center, who is overseeing the phase 3 trials sponsored by the National Institutes of Health.

Although trial coordinators are not specifically focused on obesity as a potential complication, Corey said, participants’ BMI will be documented and results evaluated.

Dr. Timothy Garvey, an endocrinologist and director of diabetes research at the University of Alabama, was among those who stressed that, despite the lingering questions, it is still safer for obese people to get vaccinated than not.

“The influenza vaccine still works in patients with obesity, but just not as well,” Garvey said. “We still want them to get vaccinated.”

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Memorial Day And Love Lost

Peggy S. Harris and 1st Lt. Billie D. Harris were married for just six weeks before Harris deployed in World War II. His wife never saw him again. His plane was shot down and crashed into the woods near a small town in Normandy. It took Peggy 60 years to find his grave.

For many of us, the coronavirus shutdowns mean being separated from loved ones, and most of us are longing for a return to the social activities we once enjoyed.

But our inconveniences and hardships pale by comparison to the ordeals faced by those whose relationships were torn apart by war. Since 1775, the U.S. has lost 1.36 million of its people to warfare. And while the vast majority were young men, most of them left behind family, a lover, a fiancé, or a wife and children.

Here are a few snippets of wartime correspondence bearing testimony of the sacrifices made.

At the age of 23, Frank M. Elliott left Georgetown University to join the U.S. Army in 1943. From England, he writes to his wife: 

May 6, 1944

Dearest Darling,

All day I have been fighting the feeling which has been dominating me of late. I keep continually thinking of home and longing for home in the worst way. All your letters of how beautiful my daughter is becoming by the day. The realization that I am missing all these months and years of her formative growth is actually gnawing at my heart. ...

I love you, Frank

Pauline “Polly” Elliott, 24, answers from the couple’s home in New Castle, Pennsylvania. They had a little daughter, DeRonda “Dee”.

May 28, 1944

Darling—

Here it is Sunday again — Sunday night. I think this is the most lonely time of the whole week for me. I am so darn lonesome for you, Frank darling. Oh I’m not the only one and I know it — there are millions just like me, wishing with all the strength of their hearts and minds for the return of peace and loved ones. — Dee is sleeping on this Sunday night, and the radio is playing old and beautiful music — and I am thinking of the Sunday nights to come when you will be listening to such music with me. — Took Dad to a ball game today — Dee went along — maybe she’ll learn to like baseball as well as her Daddy does — I’ll bet that she will.

I adore you, Polly

A week later, she writes to him:

June 5, 1944

Darling,


 . . This is a beautiful summer evening, darling. I am sitting at the kitchen table (and not even noticing the noise of the refrigerator) from which place by merely lifting my head and looking out the window I can gaze upon a truly silvery, full moon. It’s beautiful, dear — really beautiful, and it has succeeded in making me very sentimental. I had begun to think that I was becoming immune to the moon’s enchantment — so often I have looked at it without you and to keep myself from going mad told myself “It’s pretty, yes — but, so what?”. . . That’s not the way it really is though, darling — the sight of that shining moon up there — the moon that shines on you, too — fills me with romance — ; and even though it’s just a dream now, it’s a promise of a glorious future with one I love more than life. The darned old moon keeps shining for us, darling — and even as it now increases that inescapable loneliness, it also increases my confidence in the future. I truly love you . . .

Frank M. Elliott was killed the next day, June 6, 1944 (D-Day). 

Here’s a letter written by a girl from Boston:

A letter from Barth, Germany, dated May 10, 1945:

Sweetheart,

At last I can write you and say just what I please.  I don’t know whether this will reach you before I get home, but it’s worth taking the chance.  You cannot realize the joy I have experienced at being liberated, and the prospects of being with you soon.  The Germans pulled out of here on April 30th, and we took over.  The Russians arrived on May 2.  Since then we have been impatiently waiting to get out of here…

…It has been a long time and you have not been out of my thoughts for one minute.  I’ll close now, sweetheart, hoping and praying that we will be together very soon for all time.  I love you with all my heart.

Your loving husband,

Arnold

Lieutenant Arnold L. Gray and Hazel J. Gray were reunited and lived a happy life after the war.

Here’s an excerpt from a letter written by 23-year-old Lt. Richard G. Fowler, a U.S. Army Air Forces navigator from Minnesota, to his wife Cornelia.

May 25, 1944

My darling Cornie —

This is my first letter to you in almost five weeks! And I’m writing it not knowing when I’ll be able to mail it, since believe it or not, I’m behind enemy lines.

Fowler’s B-24 bomber had been shot down over the Balkans. 8 crewmen where killed, but Fowler and another man were able to bail out on parachutes.

When I was certain the chute was open, I looked up and saw the white silk billowing and swaying in the wind. It was very quiet and you have no sensation of falling until you near the ground—just floating in space. My face and right hand had been burned quite badly and hurt like the very devil. A thousand thoughts ran through my head as I was falling. It took about ten minutes before I hit the ground so I did have time to think. First of all I wondered what you would think not hearing from me for a long time—I was quite certain I would be captured by the Germans and taken to a prison camp in Germany.

Lt. Fowler survived the war and was eventually reunited with his wife. Many other families were not so lucky:

This Memorial Day, let’s also consider those whose hopes for love and happiness were crushed and destroyed when war took the love of their life, never to return, leaving behind a void never to be filled.

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Halley's Comet May 29, 1910

110 Years Ago: Earth’s Passage Through Comet Halley’s Tail Mesmerizes The Public

On May 19 / May 20, 1910, Earth passed through the tail of Halley’s Comet with great fanfare.

The event is meaningful to me for two reasons. First, my grandmother told me about it when I was little. She herself was a little girl in 1910, and her memories were not very detailed. But she recalled, as her strongest memory, the general feeling of excitement among the adults around her. Some must have been genuinely panicked, others were probably nervous, and yet others were mocking those who suffered from vivid superstitions.

From German: “Old woman, close the umbrella. When the comet sees you, it’ll tun around and Earth is saved.”

Today, few people know that there was actually another comet visible in the sky earlier that year of 1910. The “Great January Comet of 1910”, officially designated “C/1910 A1” was a surprise visitor in the sky. Already visible to the naked eye when it was first reported on January 12, it brightened very suddenly, to the point where it eventually became brighter than Venus, and was visible during the day.

First spotted in the southern hemisphere, it reached perihelion on January 17 with a magnitude of –5. It then declined in brightness but became a spectacular sight from the northern hemisphere in the evening twilight. By early February, its curved tail reached 50 degrees into the sky.

There were of course plenty of newspaper accounts. The public, not yet accustomed to front page astronomical news, became highly interested in comets, and in what the experts had to say — especially at a time when superstitions and the belief in metaphysics was much more widespread than today.

At the time, Halley’s Comet, which had been known since ancient times, had been calculated to reach its perihelion on April 20, based on Newtonian physics and the work of Edmond Halley.

Illustration from the January 1910 issue of Popular Science Monthly magazine, showing how Halley’s tail points away from the Sun as it passes through the inner Solar System

Astrophotography and astrospectography were new fields, they were used to detect toxic gas cyanogen gas in the comet’s tail. The highly famous French astronomer and author Nicolas Camille Flammarion speculated that, when Earth passed through the tail, the poison gas “would impregnate the atmosphere and possibly snuff out all life on the planet.”

Flammarion was not only a genius scientist and author, but also a man with rather esoteric beliefs. He believed not only in the transmigration of souls, but also in telepathy, apparitions, hauntings, and “psychic forces”.

Very quickly, all manner of profiteers, charlatans, mystics, and those purporting to possess special astrological insights, seized on the opportunity, and soon, the panicked public was buying up quack “anti-comet pills”, “anti-comet umbrellas” and gas masks. Sadly, we even find newspaper accounts of people committing suicide because they didn’t want to see the catastrophe.

Considering the nature of what left the strongest impression in my grandmother’s memories, I wonder what today’s small children will remember, many decades from now, about the current COVID-19 crisis. Surely, it will be memories about how we adults reacted, which should also give us reason for contemplation.

The other reason why Halley’s Comet interests me is its association with one of my favorite authors and personalities. Mark Twain was born November 30, 1835, exactly two weeks after the comet’s previous perihelion. In his autobiography of 1908, he writes:

I came in with Halley’s comet in 1835. It is coming again next year, and I expect to go out with it. It will be the greatest disappointment of my life if I don’t go out with Halley’s comet. The Almighty has said, no doubt: ‘Now here are these two unaccountable freaks; they came in together, they must go out together.’

Twain died on 21 April 1910, the day following the comet’s subsequent perihelion. This is how the comet looked that day:

Portion of Plate b41215 of Halley’s comet taken on April 21, 1910 from Arequipa, Peru with the 8-inch Bache Doublet, Voigtlander. The exposure was 30 minutes centered on 23h41m29s R.A. and +07d21m09s Declination.

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Old-School Oils On Modern Pocket Knives?

In online forums, people frequently ask if traditional oils such as 3-In-One (or gun oils such as Hoppe’s No. 9) are a good choice for use on pocket knives. Here’s my answer, based on some history and science behind it.

3-In-One oil was first sold in 1894. It was originally marketed for use on bicycles and bicycle chains. Over generations, it grew into a quintessential American product used on just about any moving metal parts imaginable – including millions of folding knives. Even today, many people still swear by it. It performs its main function (that of lubrication) very well, is widely and easily available, and costs only a fraction of fancy modern high-tech lubricants. (I might add that traditionalists often deride the latest lubricants as overpriced, overhyped snake oils). But is it the best option?

Old-school gun oils, such as Hoppe’s No. 9 or others, also lubricate very well (or even better) than 3-In-One. But all of these products have something in common: they were all formulated at a time when high-carbon steels were the norm for guns, knives and moving parts in machinery. These steels rust when coming into contact with oxygen, especially so in the presence of water. Therefore, old time lubricants include compounds meant to “stick” to the steel and isolating it from oxygen and water as much as possible. As other, shorter-chained hydrocarbons evaporate over time, a higher percentage of the longer-chained, more viscous compounds remain. In addition, all oils will eventually undergo chemical changes. They will also pick up dust and debris. All of this combines to make them more gummy, grimy, dry or gritty over a period of time.

Is this a problem in an application like folding pocket knives? Not really, but it depends. I believe the criticism of oils like gun oils and 3-In-One is mostly based on user error and therefore undeserved. What happened is that collectors have dabbed these oils on, and then put away their treasures without really using them for long periods of time. Surprise surprise: the moving parts became awfully sticky. And since collectors tend to be accepted as authorities and opinion leaders by the general public, negative assessments of traditional oils became blown out of proportion.

That’s not really a problem for the every day user who follows a simple rule of maintenance: Don’t just oil you pocket knife and put it away. Whether you do or don’t use it, clean the old lubricant off from time to time. Do this in regular intervals or before it comes gunky. Use some type of solvent (maybe just soapy water and an old but clean toothbrush perhaps). Then rinse and dry thoroughly, and apply fresh lubricant.

Another point to consider is the steel from which your pocket knife is made. The vast majority of today’s pocket knives are made from a number of types of stainless steels. Since these do not require the level of corrosion protection needed for older high carbon steels, why would you need the more problematic compounds included in old-school oils? For something like a Victorinox Swiss Army Knife (Ibach, Switzerland), or the products of Buck Knives (Post Falls, Idaho) – you probably don’t.

The standard blade of the iconic Buck 110 folder is made from heat treated 420HC steel, which is highly corrosion resistant. This kind of steel doesn’t require the anti-corrosive compounds found in old-school lubricants designed for high carbon steels.

Another problem that may or may not concern you: 3-In-One oil and gun oils are not rated as harmless for human consumption. (That’s true for all petroleum-derived oils, with pure food grade mineral oil being the only commercially available exception I’m aware of). Does that matter? I doubt it, given the very small amounts of oil that might end up into your food. After all, you are not going to simmer your entire folding knife in your soup pot. (Hopefully). However, some of these oils may have a smell that could be unappetizing when you eat.

If you are concerned about toxicity, the old-school Ballistol, would be a non-toxic, extremely capable option. (I still would not recommend pouring it over your salad). Ballistol is the stuff of legend too numerous to recount here. It predates World War-I and has many highly compelling qualities. Among them are the very high stability and anti-corrosion properties, even on high carbon steel, and at great temperature ranges. Curiously, Ballistol emulsifies quite easily with water, which makes it even more slippery when it gets wet. German makers of carbon steel blades (for instance, OTTER-Messer of Solingen, Germany) actually recommend Ballistol to lubricate and inhibit rust on old-fashioned, high-carbon steel knives. They have even been known to ship some of their carbon-blades with a sealed Ballistol-soaked pad). Ballistol has a great number of uses around the house, which makes it a great, universal all-round product to keep around. The only downsides here: Ballistol has a mild but distinct sweet licorice-like scent, which some people find unpleasant. Conversely, other people love it. Another possible downside: it’s not very widely available. Then again, it is easy to order online these days.

If you are concerned about both toxicity and scent, the aforementioned food grade mineral oil would be an odorless alternative. A natural and plant based choice would be pure jojoba oil or “wax”, which comes from the seeds of Simmondsia chinensis, of a shrub of the North American Southwest. Refined jojoba oil is both colorless to slightly yellowish, and odorless. Yes, you could technically ingest it. But since our digestive system can’t break it down, it will basically function as laxative. (Even for that, it is not recommended).

Jojoba oil was reportedly used to lubricate machine guns in the past, probably because it is much more heat resistant than petroleum based old-school gun oils. A low percentage of triglycerides makes jojoba oil much more stable than other plant oils such as olive, grape seed, safflower, canola or almond oil. (Don’t put those in the moving parts of your folding knives. The same goes for animal fats such as butter or lard). Much cheaper than jojoba oil and available just about anywhere nowadays would be coconut oil. This one you can really eat. (If you have a high carbon blade used on food, it makes a good option for coating the blade, but not so much for the joints of a folding knife).

All that said, it must be remembered that none of these plant oils are nearly as stable as synthetic petroleum based oils or unique products like Ballistol. Also, the corrosion protection and lubrication capabilities of plant based oils in all temperature and humidity conditions are generally inferior to man-made lubricants – so beware.

Regardless of what kind of lubricant you use, my main recommendation is this: clean it off from time to time and apply fresh lubricant. Think of it as giving your pocket knife a regular oil change.

Bonus tip: If you use your knife to cut food (especially acidic things, like fruit), wipe it clean with a moist cloth immediately when the job is done. Then wipe it dry right away. (Even stainless steel isn’t totally “rust free”). And should you have a high carbon steel blade, rub on a little oil or fat. Don’t overthink this. Whatever kind of fat you have at hand will suffice. (Well, perhaps except salted butter). Sure, your carbon steel blade will discolor and form a “patina”, but that’s part of the fascinating aspects of carbon steel: no two blades will ever be the same – appealing to some, but not to others. Take it or leave it!

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Notre-Dame de Paris

It is impossible to understand and appreciate a gothic cathedral without experiencing it in person. That is why, for nine centuries, millions people from all over the world have gone to Notre-Dame. Not anymore. This is endlessly horrific — not just for Paris, and not just for France, but for all mankind.

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Language Changes?

James Lincoln Warren.
Photo: Reinhard Kargl

By James Lincoln Warren

I will rarely engage with people who want to argue with me about grammar and diction. They almost always open their salvoes with, “Language changes!”, as if I were utterly ignorant of this. Of course language changes. That is not the point.

Change is not a value, in and of itself.

The question people need to ask when they indulge in adopting certain changes is, “What value is in the change?”

If it is a constructive value, then well and good. If it is a destructive value, then bad.

Which naturally leads to the question, what values are we talking about, anyway?

The first and most obvious value of language is semantic clarity, but that isn’t its only function. It’s also used to promote or suppress emotions, for example. And it’s a very significant contributor to establishing group identity.

The way you talk and write is a lot like what you choose to wear. It projects your self-image. There is a distinct difference between long-lived styles and short-lived fads. It announces your sense of class. It may announce a desired impression: “I am refined”, “I am beautiful”, “I am rich”, “I am a rebel”, and so on. Image is also a value.

The forensic linguistic term for language used to establish a particular group identity is called its “register”. This includes slang, professional lingo, bureaucratese, regional dialect, and so forth. (When I was a student at the Mannes College of Music in New York back in the 70s, there was a student there named Arthur Wood or Woodley or something similar, who was a singer with a rich, sonorous baritone voice. He was from the Virgin Islands. When he talked to the other students, he spoke with a perfectly indistinguishable American accent—but when he talked to the school’s janitor, Wendell, also from the VI, he switched into a mellifluous Caribbean accent and a different syntax. It was like he was two different people—both of them very pleasant, I might add.)

Police are famous for having an international register that may not let you know where they’re from, but will definitely tell you the speaker is a cop. An example of this is the postposed “then”, meaning that “then” follows a noun instead of preceding it as is usually the case, viz., “I then proceeded to the station,” in lieu of “Then I went to the station.” (“Proceeded” is also a register marker, of course.)

This is not standard usage, but I have no problem with it, other than the fact that it lacks grace. It has value to its users.

Likewise with slang, although sometimes it fails when it pretends to be standard—I recently read a short phrase online wherein someone described himself as a “sapiophile”. I had never run across that word before, and couldn’t find it in the Oxford English Dictionary. That’s because it’s actually slang. It’s supposed to mean “a person who likes intelligent people.” I think it’s highfalutin nonsense, used to try to make the speaker sound smart by using a word that seems sophisticated, with the connotation being, “if you don’t know what this words means, it’s because you aren’t as smart as I am, so I won’t like you.”

How is that adding value to the language?

The worst offenses, though, are those that reduce the meanings of words, like the ubiquitous “awesome”. It is now impossible to use that word to describe something that inspires awe. It used to be an age identifier, but that has long since evaporated, too. Now it’s just insipid.

But I’m not going to argue with anybody about it, one on one. Use of language absolutely is tied in with identity, and confronting someone with a consistent misusage is like rapping their knuckles everytime they make a mistake, punishing them for being stupid or slow.

Margaret corrects me everytime I make an error, but since part of MY identity is wrapped up in ensuring standard usage, I am grateful for the corrections. Plus, I usually know better than to argue with my wife.

So—please don’t justify using a barbarism on the grounds that language changes. I know it does. I am not trying to arrest changes. I’m only trying to weed out the bad ones.

[Guest post courtesy of James Lincoln Warren]

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Am I Dead?

I regret to inform you that I have been murdered. That’s at least according to a local press report in the Santa Monica Observer . Since I serve as chairman on the local neighborhood council (which is no small feat for a “transient from San Diego”), I have no doubt that there are those who want me dead.

But, in the words of one of my favorite authors (Mark Twain), the reports of my death are greatly exaggerated.

(click or tap to enlarge)

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What Is Novichok?

On March 4, 2018, former Russian intelligence officer Sergei Skripal and his daughter Yulia were poisoned in the English city of Salisbury. Since then, journalists have been scrambling to find out more about the alleged poison, a mysterious substance identified by British authorities as “Novichok”.

First off, it isn’t just one chemical, but appears to be a whole new class of nerve agents, a type of chemical weapons which disrupt the mechanisms by which nerves control vital body functions.

So far, we are familiar with two main classes of nerve agents. The “G-series” was first synthesized by German scientists during World War II. Among this group are tabun, also known as “GA” (invented in 1936), sarin, also known as “GB” (invented in 1939) and soman, also known as “GD” (invented in 1944). (Interesting detail: the Third Reich’s military refused to deploy nerve agents as weapons even though by the end of the war, between 500 kg to 10 tons had been produced. But that’s another story). After the war, GF (cyclosarin) was added to this group in 1949.

The second group, the V-series agents, go back to mostly British development, which was continued with work done the U.S. and the Soviet Union during the Cold War. Members of this class are VE, VG, VM, VR, and VX.

Novichok (Russian: Новичо́к, “newcomer”) seems to be a class of nerve agents different from the two above. It was developed by the Soviet Union during the 1970s and 1980s as part of a secret weapons program reportedly named “Foliant”. The specific intent was to be undetectable by standard NATO methods at the time, to defeat NATO protective gear, and to circumvent the Chemical Weapons Convention list of controlled precursors and classes of chemicals. All in all, over 100 chemical variants were developed and tested.

Most of what little is in the public domain about this can be traced to publications by two Russian chemists, Lev Fedorov and Vil Mirzayanov, writing for the Moskovskiye Novosti weekly in 1992. Mirzayanov claimed he made his disclosure out of environmental concerns, after measuring levels of deadly substances 80 times greater than the maximum safe concentration in the vicinity of Russian chemical weapons facilities. Mirzayanov was arrested in October 1992 and charged with high treason. He served some time in prison, and subsequent to his release, left Russia to live in the U.S. However, during Mirzayanov’s trial, some more details about the Novichok program emerged, and the Russian military was forced to acknowledge the existence of this group of chemicals.

According to Mirzayanov, the most potent compounds from this family, Novichok-5 and Novichok-7, are supposedly around five to eight times more potent than VX. The agents are reportedly capable of being delivered as a liquid, aerosol or gas via a variety of delivery systems, including bombs, missiles, artillery shells and spraying devices.

The absorption of nerve agents into the human body can be by skin contact, ingestion, inhalation or injection. Generally speaking, these chemicals were conceptualized as weapons of mass destruction and for wide dispersement. The pin-point use as murder weapons in targeted assassinations appears to have been an afterthought. But it is now well documented in several instances, such as the murders of Russian banker Ivan Kivelidi and his secretary Zara Ismailov in 1995, or the killing of Kim Jong-nam in Malaysia on February 13, 2017. (The U.S. Department of State has claimed the assassination was a plot conducted by agents of North Korea, using VX).

And here it gets extremely troubling. It would appear that nerve agents, due to their rapid effectiveness in extremely small doses, make ideal weapons for assassinations. However, these chemicals require highly specialized skills and facilities to develop, manufacture and deploy – all of which is difficult to conduct except in the presence of state-sponsored weapons programs. Even where chemical weapons treaties led to the controlled and audited destruction of chemical weapons of mass destruction, there can be no doubt that small batches of all these substances were retained, and that of course, the process of making them (even in very small quantities) is well understood by those who were involved in these military weapons programs.

So are we looking at a coming new era of silent state-sponsored assassinations? Could this become a method for governments or institutions to get rid of regime critics, political dissenters or opponents, alleged traitors, whistleblowers and others deemed a threat, on a large scale?

It could well be. The other options – an illicit trade of these substances, or the possibility that criminal organizations, terrorist groups or rogue individuals may have found ways to cook them up in hidden labs – are equally scary.

Either way this will play out, the future on this issue looks gloomy.

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