Chickenpox jab UK rollout, and how the US grabbed Maduro

0:11Hello,

0:16welcome to the Naked Scientist podcast. This is the programme that brings you the biggest breakthroughs and talks to the major movers and shakers in the worlds of science, technology and medicine. I'm Chris Smith. Coming up, infants in the UK begin to receive chicken pox jabs. But what took us so long? The daring technological mission to capture Venezuela's Nicolas Maduro, and why children eating vegan and vegetarian diets might be shorter.

0:50From this month, young children in the UK are now being offered protection against chickenpox virus by the NHS, the National Health Service, for the first time. The vaccine, known as MMRV, is given in combination with the existing MMR jab, which is offered at 12 and 18 months of age, and it's expected to reduce the number of families who are affected by chickenpox every single year. But why is the UK only rolling out the vaccine now when it's been used safely for decades in other countries like the US and in Australia. Here's Sir Andrew Pollard from the Oxford Vaccine Group. Chickenpox is a virus which affects almost all children by the time they reach 10 years of age and usually they acquire it from one of their brothers or sisters or from another child either at nursery or at some other play group and starts with a really high temperature which can last for a couple of days and then they start developing the rash all over the body as spots which tend to blister and then eventually crust over and become very itchy.

2:01The period of time that the spots come out usually lasts about five days or so and most children despite having a very miserable time will fully recover. Unfortunately, there are a small proportion who develop very severe complications of chickenpox, some developing a brain infection with the virus or severe pneumonia. The most common complication we see are actually bacterial infections, which occur in children with chickenpox and can be very severe and life-threatening, just like those other viral complications. The other thing we worry about, of course, is that this virus keeps coming back, doesn't it?

2:37Because it persists in the nervous system throughout life and we can get nasty manifestations as we get older. Absolutely. So once we've had chickenpox as a child, the virus lives with us for the whole of our lives, as you say, sitting in the nervous system. And over time, immunity against that virus reduces. And increasingly commonly over the age of 55, people develop shingles, which in itself is pretty miserable, looks very similar to the chickenpox rash. But the main problem with it is some, after recovery, will develop long-term pain in the bit of the skin where the shingles rash has come out.

3:24And that's not only unpleasant for them, but it's also very expensive for the NHS to treat. And therefore, the rationale for the vaccine is what exactly? Because if 90 % of the population have been catching this for thousands of years, why do we need a vaccine for it now? What's the motivation? Well, the motivation for vaccination is chiefly around to try to stop children from getting this miserable disease and the very serious complications that we see in the hospital. And the test that we do to decide whether it's of value to the national health system is called cost effectiveness. And there is such a burden on the health system from this virus that it actually will save money for the health service to vaccinate children.

4:14Beyond that, we also know that because parents have to take an average of five days off work to look after each child who develops chickenpox, And that's not taken into account to make decisions on new vaccine introduction, but it is another huge benefit of having pregnant. And what does the vaccine that's being introduced look like? As in, how's it being given? When's it being given and how does it work? Well, the vaccine is actually just made of a weakened form of the chickenpox virus. And it's given as an injection at 12 months and at 18 months of age. And with that, the vast majority of people will develop a strong immune response to those two doses and then will be prevented from getting chickenpox.

5:03And indeed, in the countries that have introduced the vaccine already, they essentially see chickenpox disappear. But more importantly, from my perspective as a paediatrician, the hospitalisations and the deaths from chickenpox stop. The Americans have been doing this for about 30 years, since they, I think it was 1995, they introduced chickenpox vaccination. Why has it taken us three decades to catch up then? Yeah, so they did, as you say, introduce initially with a single dose of the vaccine, and then they switched to using two doses. Really, the data that they've accumulated about the impact of the programme is one of the things that filled in the gaps for the analysis that we do to make decisions on introducing vaccines.

5:50And there was a lot of uncertainty about some of those impacts that I was talking about. For example, just the burden on the hospital system, the data had to be generated around just how many complications of chickenpox. But the key reason why there was a slow uptake here was the uncertainty about what would happen about the rate of shingles in older adults if the vaccine was introduced. And that's because although we think the chickenpox vaccine in the long run will make shingles very, very rare. And so 60, 70, 80 years from now, shingles should really become a very rare condition. In the meantime, until we get to that point, we will have a long period of time where most of us as adults will have had chickenpox as a child.

6:40And it was thought that having our own children who had chickenpox and we were exposed to them would then boost our own immunity. And if that was true, it meant that introducing a vaccine program for children could, over some decades, increase the risk of shingles in older adults. Now, what emerged from the data from countries like the US was that that was not true, that it turns out that the importance of being exposed to your own children and chickenpox to protect you from shingles is fairly minimal. And so when you crunch the numbers, it actually makes a lot of sense to get on and vaccinate children.

7:22Professor Sir Andrew Pollard at the Oxford Vaccine Group, and you can hear our Titans of Science interview with Andy, as well as many more, by heading over to nakedscientist.com forward slash podcasts. The capture of Venezuela's president, Nicolas Maduro, in the country's capital, Caracas, was, by any estimation, quite remarkable. It involved what must have been months of planning by US authorities and some of the world's most advanced technology. Stealth drones, real-time surveillance and GPS were all deployed to keep tabs on Maduro and even his pets. Additionally, signal jamming and cyber attacks allowed the US military to disrupt Venezuela's air defence and communications ahead of the dramatic operation.

8:05We asked Ramsey Farragher, who is director of the Royal Institution of Navigation, to bring us up to speed. The US used 150 aircraft and an aircraft carrier and about a dozen vessels off the coast of Venezuela to nip in, kidnap the Venezuelan president, Maduro, and nip him back to America to be put on trial for drugs trafficking charges. And they managed to do everything I've just said all within the space of about two hours. So it was an incredible operation and I'm sure there is a Hollywood movie in the making as I speak. I actually got a little hint that something interesting was going on that morning.

8:45About three hours before the raid actually happened, all of the US military aircraft in the United States turned off their transponders, which is such an interestingly unusual thing to happen that it was being discussed on Twitter and on various WhatsApp groups that I'm on. so some of us who were interested in tracking and and what aircraft are up to what ships are up to via all of their transponders and we all figured something interesting was about to go down when that happened three hours before the raid were these the kinds of things that are piloted craft or was this as we're seeing increasingly in ukraine drones and unmanned vehicles it was just about everything in the arsenal.

9:30It was amazing that they used the Air Force, the Navy, Special Forces, the Coast Guard, their cyber units, their Space Force. Almost every branch of the military seemed to have been brought in and involved. Everything from helicopters, refueling tankers, lots of different types of aircraft, the most modern-style aircraft like the F-22 and the F-35, and older aircraft as well that are not stealthy. Lots of drones were used of various types and ages. So they really threw everything at this. And I think it was because they needed to wipe out all of the air defences. They had to ensure, I think, that the worst case scenario did not happen, which would have been Maduro being shot down and killed as they stole him from his own country.

10:16I think for various reasons, they had to ensure that did not happen. And so they used a huge barrage of Tomahawk missiles and stealthy aircraft to take out the air defences. They used other aircraft to blanket, jam and interfere with any radar units that perhaps are mobile or ones that were passive, that they didn't have a good understanding of where they were physically located. And they would have had dozens of drones providing lots of eyes from the sky in infrared and in radar to give them live understanding of the whole area that they were operating in. But this kind of operation must have been months, if not even longer than that in the planning, mustn't it?

11:00To get that executed that well takes planning. I suspect that these sorts of operations exist in playbooks that always exist. And it's a matter of updating those playbooks as the years go by, as your capabilities improve. So at some point last year, it would have first been mooted that they would try to go and get him. And probably there was discussions about whether that meant kill him or put him on trial. And then, yeah, they would have spent months actually working from that playbook to put all of this stuff together. One of the interesting things that's been going on is that in the months leading up to this kidnapping, they have been blockading the ports and trying to stop the flow of oil from Venezuela, basically oil being transferred to countries that are under sanction.

11:51And so there's been an operation going on off the coast for a number of months to do that blockade. And in fact, just a couple of hours ago, as we record this, the Americans have taken over a tanker that had been sailing under a Russian flag and had left Venezuela a few days ago. so all of that background operation of the the dark fleet and the oil sanctions and blockade that have been going on has been a very convenient and perfect cover if you like for having all of these assets just off the coast aircraft carriers destroyers of various types on the original mission of we're here to do this blockade but clearly the secondary mission was in a couple of months were going in for Maduro.

12:35And by having all of those vessels and aircraft just off the coast for so long, they'd have been able to do huge amounts of surveillance and work up this pattern of life through satellite information, drone data, and probably the special forces and spies, fundamentally, going into the area in the last few months leading up to this event. Because there's even this claim that they were watching his pets. Because you're thinking, Have they got one of those tracking collars on the dogs? It's probably eyes in the sky, isn't it, watching the pets? Because I suppose where the pets are is where the people are, and that's why they're interested in the pets.

13:12Exactly. That was mentioned in the briefing. So important enough, I think, for them to drop it in. And it could be anything from Maduro was probably moving around between different safe houses, potentially just as normal. And so in some respects, seeing from the eyes in the sky, from the drones, which dogs are running around in which garden of which residence when is probably a really good indicator as you say it could be something even more incredibly high tech like there's an air tag on the dog's collars or something like this and they know how to sneakily read air tags and things like that so um it was important enough to be mentioned and we'll wait for the hollywood movie to find out which one it was i think we will indeed that was ramsey farragher director at the Royal Institute of Navigation.

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14:20Music in the programme is sponsored by Epidemic Sound, perfect music for audio and video productions. This is the Naked Scientist podcast with me, Chris Smith. Still to come, as we cram more and more orbiting assets into space, the rising risks posed by falling debris. Before that though, children eating a vegan or vegetarian diet might not be getting all the nutrients they need from food and are more prone to be shorter in stature than their meat-eating counterparts. Those are the findings of a new meta-analysis study that has considered data from 50 ,000 individuals around the world and also shows that children and adolescents who consume solely plant-based diets are more likely to be deficient in protein, fat, zinc and the nerve-supporting vitamin B12.

15:08Jeanette Beasley at New York University co-authored the study. So we were interested in diet quality, so understanding whether people who consume vegetarian and vegan diets had a similar level of nutrient intake compared to those who consume meat and how that may or may not be associated with their growth and cardiovascular disease risk. So lipid levels and blood pressure and other cardiometabolic risk factors. And what emerged? What did you see? If diets are well planned, the children actually had better cardiometabolic risk profiles than those who consumed diets including meat but if the diets were deficient in certain nutrients then they tended to be shorter in stature and may not have been as healthful as children who were consuming meat.

16:04Now when you said they were shorter was this significant or was this that if you look with the eye of a statistician you can see a difference but in the grand scheme of things it makes no difference. What was the scale of the difference? This is a bit mixed up because tends to be a higher proportion of vegetarians in countries that have smaller stature so we don't know from the data that we have whether it was causal in nature or if it's just an observation since what we didn't do an intervention. What do you think is at the root of this? If we don't have supplementation of b12 or other nutrients that are only present in animal foods that children don't have the sufficient building blocks to grow well and so it's critically important to educate families who want plant-based diets to have a balanced diet that includes supplementation of these critical nutrients such as b12 or calcium and iron did you only consider physical stature or did you include brain growth in the analysis as well because talking to some people they argue that if you are not careful on some of these diets you can end up a bit anemic especially women you can also end up as you say b12 deficient and there can be cognitive consequences brain development may not reach your full potential for example have you looked at that we collected all of the outcomes that were reported and unfortunately brain health wasn't among them because children are a special vulnerable population so they don't tend to do brain scans in large-scale studies as they would in adults but this would be a meaningful question to ask among adults and see how it could perhaps be extrapolated to children.

17:56Were there any standouts from this though in the sense that you spotted that certain geographies or certain people or certain cultures are more at risk of some of these outcomes and therefore you can spot immediate interventions that could fix them? To me one of the standouts was that people tend to worry about protein so much when we engage it when we talk about plant-based diets but it was actually the micronutrients rather than a macronutrient that was the most lacking in these diets. And so I think, which is good news for public health, because micronutrients can be easily supplemented using a multivitamin that would correct any deficiencies, very inexpensive approach to help children grow.

18:48And was there a difference because you're saying you consider vegans and vegetarians against those eating a more omnivorous diet. I know statisticians are uncomfortable with further subgroups and dividing groups up more, but if you do group them by vegetarian, vegan, omnivores, do you see any stronger trends when you do that? That's a really great question. And as you said, we have a table comparing vegetarians and vegans, but unfortunately, there's so few data on vegans that we can't make meaningful extrapolations from the data at this time. As this is becoming more common, we'll be able to study this further or undergo an intervention that would have greater power to detect differences since we are directly changing what people are eating.

19:37A lot of people tend to approach this as a sort of binary thing. They're either a meat eater or not. Would studies like this suggest that in fact you need a bit of everything, but in fact if you just shifted towards increased representation of plants in your diet without excluding meat altogether maybe that would be the sweet spot for this it doesn't have to be an all or nothing approach where you just incorporate and complement your diet with more plant-based sources that can be actually a lot less expensive than meat sources as long as you do it wisely either with the help of a dietician or the help of evidence-based resources or the help of micronutrient supplements.

20:21Food for thought. Jeanette Beasley at New York University, that study published in critical reviews in food science and nutrition. Now, with the number of satellites and rocket launches increasing, so is the amount of space junk dumped in orbit and ultimately falling back into the Earth's atmosphere. Most items of space debris burn up harmlessly on re-entry. But not all of them, especially the larger ones, which can make it through to the lower atmosphere where they can pose a threat. Some even make it down to the ground. In 1997, for instance, Oklahoma's Lottie Williams became the first ever person documented to have been hit by falling space junk, in her case, by a lump of Delta II rocket landing on her.

21:04But the bigger and rising risk is to aviation. This year it's estimated that there's a 26 % chance of space debris passing through the world's busiest airspace, which is located in Western Europe. That, in turn, can lead to cancelled and delayed passenger flights. We asked James Blake, who's a researcher who specialises in space debris at the University of Warwick, to explain why it matters. It's many things, really, and one of the most interesting pieces of debris are, in fact, the satellites themselves. When they come to the end of their mission lifetime, they're often abandoned and are still just floating around waiting to collide with something else really off of them so you've got the dead satellites you've got often the rocket bodies that have launched those satellites to their particular orbit and one of the most numerous contributors to debris are things like collisions and explosions that have taken place in space as well.

21:58Do they tend to loiter near earth these bits or do they just float off into the void what's their long-term fate if we look at these bits of material that are there? It very much depends where they originate from. So you get some debris that's produced relatively close to the Earth. In those cases, the atmospheric drag force that's present at those altitudes will act against the object in its orbit, and that will act to effectively spiral in the objects over time if it's not counteracted. And so a lot of that debris will actually start to re-end the Earth's atmosphere. Whereas if you've got quite high altitude pieces of debris, the orbital lifetimes enter the realms of centuries, even thousands of years.

22:43Those pieces of debris present a huge issue because we can't do much about them. Do we know how much is up there? The short answer is not for sure. We have a decent idea of what we can track. So in terms of our surveillance capabilities, we're in excess of 40 odd thousand objects now that we can reliably track and catalogue. These are objects that if you wanted to know whereabouts in your night sky, you could pick them up with a telescope, say, or radar. But the worry is that a lot of the objects up there that we are concerned about are incredibly small, and they're too faint to pick up with these telescopes, radars, and so on.

23:22And it's from models, we predict that over a million of these objects are present in the near-Earth environment. So there's a huge disparity between what we can track and what we need to track. How big does something have to be to actually pose a threat though? In order to pose a threat we typically use a centimetre in size as our reference point there. The reason being for that is at the velocities that we're talking about in earth orbit we're talking velocities of order a kilometre every second so these are incredibly fast moving objects and because of that they have enough energy that even a small centimetre size piece of debris has roughly the same energy as a hand grenade and can cause a lot of damage still to your active satellites that we rely on.

24:07Obviously that's threats in space but the other problem for us down here on earth is when these things do begin to rain down and this report came out suggesting that we're going to have to start increasingly closing air spaces potentially because there is a rising risk that our passenger aircraft and commercial aircraft may encounter these things 26 seems like quite a big number yes it's notoriously been a very difficult number to to place really it's it's something that relies a lot on assumptions that are made about how the earth's atmosphere is behaving how the earth and the sun are interacting and so on all of these things factor into impacting how a re-entry takes place and so putting a particular the number on how risky it is is a very difficult question to answer.

24:55But for sure, it's a non-zero chance that these things can take place. And as we launch more of these satellites into the Earth's near-Earth environment, we'll start to see more of these cases taking place. It doesn't have to be big stuff, I presume, though, because just as you were saying, in space, where you've got things whizzing around with the energy of a hand grenade, a slightly different threat, something similarly small but dangerous comes through Earth's atmosphere, if it gets sucked into a jet engine, it could cause the engine to disintegrate or it could pierce the fuselage or smash a windscreen, for example, because the plane is going to fly into it at a thousand kilometres an hour.

25:32Absolutely. And these are legitimate concerns to have. In the short term, then, the things that probably pose the biggest risk that have the biggest chance of causing a problem, we probably can see those and we can therefore make guesstimates as to where they're likely to come down so we could potentially take avoiding action with air spaces and so on but looking longer term what's the plan is anyone actually making a map of where all this stuff is working out what we do to stop it and is anyone actually saying this has to stop we're not going to make the problem any worse yes it's it's a very challenging problem and one what it boils down to is a lot of the time surveillance and tracking and that's something that we're we're putting a lot of drive into is generating better global coverage and also placing sensors in space so not just having ground-based telescopes and radars we'll also have space-based sensors that are going to be looking at where these things are in space and the benefit of launching your telescope or whatever sensor you have into space is that you remove that barrier of the earth's atmosphere so everything becomes a lot more clear.

26:41What about cleanup though? Is anyone working on that because i mean that strikes me as if we've got 40 000 bits we do know about and potentially millions that we don't we need a way of of making or cleaning up the mess we've made absolutely the the key drive for that is targeting very large abandoned objects i mean the reason for that is the the larger objects contain the most mass and mass is essentially correlated with the number of fragments that that could be produced from say a collision or explosion involving that spacecraft. So one of the main drives that we have is developing these what we call active debris removal missions and these will launch up into space, typically dock or grab a large object and then have the fuel on board necessary to de-orbit that object and remove it from the environment before a collision or an explosion can take place.

27:34Is that on a piece-by-piece basis because that sounds really expensive or will you have some kind of craft that will go around and grab a threshold cargo as it were and once it's got critical mass it just drags the whole lot down safely yeah so this is one of the main challenges that persists at the current time and and it's what's preventing the active removal realm from from taking off as a commercially viable way of doing things and so as you say what we would ideally want to do is launch a sort of servicer spacecraft make its way round to the to the clients if you like and collect many multiple spacecraft and bring them back to earth so we've made a mess on earth now we're making a mess in orbit and still no signs of how we're going to clear it up thanks very much to james blake at the university of warwick there well that's it for today do join us on tuesday though when we're going to be previewing the frontiers science house and finding out how the open source publisher is pushing science to the top of the agenda at the forthcoming world economic forum in davos thanks to all of you who continue to support the naked scientists on a regular basis your donations really do make a difference if you'd like to help us you can go to nakedscientist.com forward slash donate thank you very much indeed we really appreciate that the naked scientist is also supported by rolls-royce i'm chris smith thank you for listening from all of us here at the team a very happy new year again and until next time goodbye