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COVID-19 Update December 17, 2020: Advanced Pediatrics Signs up, Let’s Make It to the Vaccine and a Thank You to Human Imagination

By Dr. Arthur Lavin

Glossary

  • Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
  • Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
  • SARS-CoV-2– the specific name of the new coronavirus
  • COVID-19-the name of the illness that the new coronavirus is causing
  • Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
  • Epidemic– a sudden burst of an illness that comes and goes over a limited time
  • Pandemic– an epidemic that bursts across the world not just one region
  • Spreadability– how contagious is the disease, how many people will end up infected
  • Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
    • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
    • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
  • Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
  • Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
  • Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
  • Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
  • Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
  • Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
  • Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.
  • Vaccine Terms
    • Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
    • Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
    • mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
    • mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
    • Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

 

Advanced Pediatrics Signs up: The Docs and Staff to Be Immunized Against COVID-19

Yesterday, the doctors and staff of Advanced Pediatrics were deeply grateful to hear from the Ohio Department of Health that we are registered to be immunized against COVID-19.   As front-line health care workers we have been assigned a priority position to receive vaccine from the Cuyahoga County Board of Health (CCBH).  Our registration is now official and we are told to anticipate a call when the COVID-19 vaccine is delivered to CCBH for the docs and staff to report to the COVID-19 County immunization site when called.

We do this first of all to protect all we care for from being an unwitting transmitter of the virus, a risk made all the more real by some of us, including myself, turning positive during our care of all the families we care for.  Once immunized, we will reduce the chance of catching, and of spreading, the SARS-CoV-2 virus, by an amount that is anticipated to be substantial.

We do this also, as everyone should, to protect ourselves from getting infected and very ill, by a proven 95% degree.

We do this to make perfectly clear that we have examined the facts closely, we know the science of this new mRNA vaccine well, and we are making a public statement of confidence in these COVID-19 vaccines.  The data are convincing, they work well, and they are safe.  Not all answers are in on the vaccine, how long it will last, what will be the very rare side effects, but we do know that the choice is clear- forgo the vaccine and live with 3,000 deaths every day in our nation.  Or take the vaccine, and very likely end the losses.

Finally, we do this, because we want to save lives.  We hope that if we get the COVID-19 vaccine, others will.  We are confident that if enough of America gets the COVID-19 vaccine, the nightmare can end, the endless loss of life coming to an end.

A New Goal: Let’s Make It to the Vaccine

At the start of this year, and throughout 2020, we said to each other, “Be well,” or, “We hope everyone stays healthy.”  The hope was real, the duration we would be forced to hope remained vague.  No one knew, but it seemed that the threat of a deadly infection might loom for 2-3 years.   There was really no end in sight.

Lately, the decision in our nation to let the virus run rampant has taken hold.  Yesterday, University Hospitals reported that overall tests have yielded a 30% or more positivity rate.  This is simply devastating.  New York City is responding to a 5% positivity rate as catastrophic, leading them to shut down all indoor eating in NYC in winter, and weigh closing all schools.   Remember, Dr. Osterholm has noted that once over a 10% positivity rate, a community must anticipate large outbreaks, and great jumps in loss of life.  We have seen all this right here.

The data from UH show that the positivity rates are over 10% at all ages:

  • 0-5 year olds 13.7%
  • 6-10 year olds 20.7%
  • 11-15 year olds 31.6%
  • 16-20 year olds 34.9%

Under any other circumstance, the focus would be on the grave danger we all face right now, and that focus needs to be maintained until we are all immunized, because our danger is quite grave.

But now Americans, people around the world, are getting the COVID-19 vaccine.  The US has 300 million doses committed for manufacture and delivery.  The first Americans are already immunized across our nation.  An end is in sight.

Dr. Tony Fauci anticipates that front line workers and nursing home residents will be immunized by the end of March, and that general population immunization will take hold then.   If we all agree to be protected, we could see the pandemic begin to recede dramatically by the end of May or June.  Those dates are not set, they are aspirations, but seem within reach.

The question of children being immunized is on the horizon too.  The current Pfizer vaccine is approved for children 16 years and older.  Both Moderna and Pfizer are launching studies of children 12 years and older which may allow these vaccines to be proven safe at that age and available by the fall of 2021 or beginning of 2022.

And so now greetings will begin to shift to “Let’s make it to the vaccine!”

A Special Thanks to Human Imagination

My take home sense of the situation is that the power of human imagination hit a historic home run this time.

I mean, just think about it.   A virus, never seen in humanity before, appears.

And within weeks, we know:

  1. The virus’ complete genetic code
  2.  That those spike proteins are the signal our body uses to abolish this virus totally.
  3. The specific part of the virus’ genetic code that makes a cell make those spike proteins
  4. How to make gallons of this specific part of the virus’ genetic code in a lab

And, within months, we can:

Make a vaccine out of that specific part of the virus’ genetic code for its spike protein that works 95% of the time!

All this is the culmination of centuries of science, and 30 years of work on the mRNA platform for vaccines, it is the result of human imagination, hard work, throwing out failures, searching for successes.

This is not the story of a rush to judgment, or a rushed creative or approval process.  As noted in a recent post in Real Answers, the vaccine that I will be given has been in development for over 30 years.  It is the application of this vaccine’s technology to this specific virus that took just a few months.  But that was the whole point of the last 30 years of development, to create a vaccine creation platform that could go from discovering the new virus to a new vaccine, reliably, safely, in a matter of months.

And, it worked!

It is a fabulous human triumph of reason and thinking and problem-solving.

Bottom Lines

  1. COVID-19 continues to rage across America.   The virus is spreading widely and wildly still.  It remains URGENT that we all decide to not travel, not gather, keep distant.  If outside the home, wear a  mask, stay 6 feet apart.
  2. But in the next 6 or so months we will almost certainly see COVID-19 vaccine given right here in our community, and across the US, it has already begun.
  3. Advanced Pediatrics has been offered to be immunized and we have agreed.  The doctors and staff will be called by the public health authorities in the next few weeks to report to the County site for Tier 1 recipients, and we go glad to protect ourselves and others, to save life.
  4. With the COVID-19 vaccines rolling out, it now makes sense to say, “Let’s make it to the vaccine.”  We hope we all do, and urge everyone to prepare to be immunized when the opportunity arrives.
  5. And once more, we tip our hat to human imagination, and its ability to solve problems.  This time the 30 year quest to find a path to be able to respond rapidly when a new deadly virus appears has born fruit.

 

My Takeaway- in One Sentence:

Let’s all make it to the vaccine, and in good health!

To your health,
Dr. Arthur Lavin

 

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