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.
• Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines.
• 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.

Choosing the Pandemic, Breeding the Variants: Who It Hurts

Every nation has had a dramatic response to the appearance of a devastating Pandemic.

For some the drama has involved careful isolation of initial outbreaks, for others the drama of abandoning the nation to the virus’ devastation.

These dramas are familiar across history, as plagues routinely appeared, nations grappled with tough choices and then lived with those choices and the power of the plague.

But now all of us in America are living in a reality that no nation has likely every experienced.

Right now in America, we are living through the widespread phenomenon of millions of people actively choosing to be infected, to put their lives at the mercy of a deadly virus, and to breed variants that could harm us all.

Why This Moment is So Unique

Most plagues in history had no cure or reliable paths to prevention.  More recent plagues have.

For those with no cure or prevention, what we did as humans made little difference. Think of the Black Death which killed a third of Europe in its worst years. The option of antibiotics, the only option that has ended this periodic plague, was simply not available, and so the germ ruled the world, not people.

But with the advent of antibiotic and vaccine, those scenes changed forever.  In the 1950’s we had a vaccine for polio when the polio epidemics hit.  So now humanity had a choice- let the polio virus continue to paralyze thousands of children, or stop the virus.  In the 1950’s humanity chose to stop the virus, and we did.  Now, do any of you know anyone who has been paralyzed by polio?  If your answer is no, there is truly only one reason you don’t- the polio vaccine.

Right now, 2021, the United States is being forced to live through a terribly unique moment.  For the first time in human history, millions of people across a nation are actively choosing to let a deadly Pandemic flash through our people.  Like in the 1950’s we have a tool to stop the Plague, a vaccine.

But in deadly and tragic contrast to the 1950’s, this time large swaths of America have actively chosen to help the virus continue to kill, rather than end the Pandemic.

Who has Chosen the Pandemic

We now know for a fact and with no doubt that communities that have chosen to be COVID vaccinated have seen this Pandemic essentially cease.

This means we can be sure that if America broadly decided to get immunized, we have it in our power to completely crush the Pandemic, to end it, to have days, weeks, years, where no one dies of COVID, where no new cases occur.

But that is not the country we currently live in.  Enough Americans have chosen not to vaccinate, that the virus is experiencing a powerful invitation to continue to infect, to sicken, to kill, and to spread to continue doing all these things and more.

As of July 9, 2021, the CDC reports that millions of Americans who could choose to stop the Plague, have instead chosen to keep the Pandemic roaring.  https://covid.cdc.gov/covid-data-tracker/#vaccination-demographics-trends

The pattern of such choices varies strongly by age, here is the percent of Americans who are not vaccinated, by age:

Less than 12 years old- nearly 100%, because they cannot be vaccinated yet

12-15 year olds- 75%

16-17 year olds- 63%

18-24 year olds- 59%

25-39 year olds- 53%

40-49 year olds- 44%

50-64 year olds- 34%

65-74 year olds- 19%

>75 year olds- 23%

Take a moment, catch your breath, look at these numbers for a moment.  Because these numbers will define the life of this Pandemic for you and all you love for the foreseeable future.

For me a number of patterns jump out

First- When it comes to parents choosing whether to end the Pandemic, a rather stunning majority have decided to keep the Pandemic roaring, for their kids.  A stunning 60-75% of children who could be protected, have parents who have decided to not protect them, to keep COVID spreading and killing.

Second- When it comes to adults who make up their own mind, the idea of choosing to keep this catastrophic bringer of death and suffering going seems most popular the younger the adult.  Only when people achieve the ripe age of 40 do a majority of any age group opt to put an end to the Pandemic and get vaccinated.

In America, where COVID vaccine flows like water, where nearly anyone ages 12 and up can get it for free pretty easily, a majority of adults under age 65 have opted not to stop the dying. 

Isn’t it powerful to observe those Americans who are most likely to immediately experience the deadly harm of choosing to keep the Pandemic going are the only ones who achieve something like 80% vaccination rates?  That would be those ages 65 and up.

And Now the Death that Choosing the Pandemic Has Brought Us

Across America, right now, we are all forced to see the obvious, but deadly truth.

Get vaccinated and the Pandemic essentially ends.

Choose to not get vaccinated and the death continues to envelop you and those you love.

It is really no surprise, and has long been predicted, but the tragedy is now in full view:  in most counties in the United States right now, about 99% of those COVID has hospitalized or killed chose not to be vaccinated.

It’s not only death and getting sick enough to need a hospital that follow the choice not to be COVID vaccinated, but the spread of the disease.  Groups that achieve high levels of COVID vaccination simply see almost no cases of COVID. COVID is spreading now only in places where people continue to invite it to spread.

Breeding Variants

We all now know that when someone breathes in COVID and gets infected, they breathe out new forms of the virus.  Most of these new forms are not very different, but some are.

The lab where we send our COVID tests informs us that there are right now about 7 such new forms, or mutations, or variants, that are different enough to behave substantially different.

Lucky for us, all 7 pose little threat to all of us who are COVID vaccinated.  But already we are seeing that wall begin to bend. Most of the 7 kill more easily, spread more easily, and so are far more deadly.

One of these variants, the Delta variant, spreads so much better that it can cause new massive outbreaks across nations that have achieved immunization rates as high as 45%, like us.  The other currently spreading 6 variants have not been able to do this, but Delta can, and is.

Now, here is the problem.  As thousands of people continue to catch and spread COVID, they are literally breeding variants.  It is certain that as COVID continues to spread, new forms will emerge.

Who knows, maybe we will be lucky, and none of the new variants will find a way to kill all of us who are vaccinated.  But maybe we will not be lucky, and some of the new variants will find that way.

One thing we know for sure, if enough of humanity was vaccinated, we could, today, end all of COVID, as surely as we have stopped smallpox and polio.  And, if we stopped all spread of COVID, it would be impossible for new COVID variants to emerge.

And so choosing not be vaccinated for COVID if 18 and up, or to not let your child be COVID vaccinated for those 12-17 years old, not only is a choice to support the continued spread and devastation of the Pandemic, but it is an active choice to continue to breed variants, one of which one day, could very easily put everyone now vaccinated against COVID of succumbing to this disease.

Who Gets Hurt By Choosing the Pandemic

Our Children

The first group to talk about are our children.  Until the COVID vaccine is authorized for use in all ages, we will live in a reality in which all children under a certain age will be unimmunized, because the vaccine cannot be given to them.

Until all ages are allowed to be COVID vaccinated, children under that age are trapped in danger.

What danger?

As long as COVID spreads, every single person, of any age who is unimmunized can be infected.  Again, this is being demonstrated every day in the United States.  Uninfected people right now are being infected by COVID in every state.  And right now the Delta variant is stepping up that danger quite dramatically.

So one danger is getting COVID, and that danger is present for every single child under the age of 12 in the United States.

But the other danger is just as important, if not more so, for our children 12 and under.  It is the unknown impact of COVID across many, many years of life.  One thing we know about COVID is that it does damage to many organs of the body.  We know that damage is often hidden, only becoming known months after infection.  What we have no idea about is what this virus can do to a young person who has a very mild infection.

Our hope, of course, is that a mild, or even asymptomatic COVID infection will leave anyone with such a mild experience completely unharmed across their life.  And that possibility remains very, very real, thankfully.

But we do not know, and will not know for many, many years how any one child will do across their lifetime.

Given this deep reality, it seems compelling to take any steps we can to keep our children, who wait with no chance to be protected by their own COVID vaccination, from getting COVID.

By far, by far the best way to protect all children unable to be immunized, currently including all children in the world under 12 years old, is to have everyone 12 and up COVID vaccinated.  Period.

So, the choice to not be COVID vaccinated not only puts your life at risk, allows the Pandemic to continue, the COVID virus to spread, variants that could endanger everyone to emerge, but directly puts the lives of all our children under the age of 12 at risk.

The Unimmunized

Exactly the same issues for all children who cannot be COVID vaccinated, currently everyone under age 12, applies to everyone who is unimmunized.  Right now, today, if you choose not to be COVID vaccinated, you help spread the Pandemic to all the unimmunized.

One further danger is presented to the unimmunized, and that danger varies by age and medical condition.  And that is harm from COVID during or shortly after the infection, this is the danger discussed in above sections, the ongoing dying and harm done as we permit the Pandemic to live.

Everyone

The final group to present who will be harmed if we continue to choose to let the Pandemic rage.  That group would be you, me, and everyone.

Why everyone, isn’t one of the main points made here is that the immunized are safe?

But in the section above on Breeding Variants, it is made clear that if we choose to let the Pandemic continue to rage, it is guaranteed that new variants will emerge.

What we don’t know is whether the next COVID variant, or any emerging COVID variant will be able to infect and kill anyone fully vaccinated.  So far, none have emerged.

But we are playing with fire.  By letting the Pandemic rage, we are certainly Breeding new Variants, and if one does emerge that can infect and kill all the vaccinated, then this choice does indeed put you, me, and all the immunized in direct and dire danger.

Bottom Lines

1. The inevitable has come to pass.  We now live in a nation where essentially everyone is choosing- Will we end the Pandemic or choose the Pandemic?  Will we stop new variants from emerging, or Breed the Variants?
2. Right now, in real time, you can see each choice at work.  Communities that have chosen the vaccine over the Pandemic are seeing the Pandemic cease to be.  Communities that have chosen the Pandemic are experiencing its deadly course and are right now breeding variants.
3. For the sake of each and every living person, we hope everyone lets go of their love of this Pandemic, ends the pleasure of ignoring it, forgoes the thrill of sticking to a team calling for you to not vaccinate you or your children.  We hope everyone 12 and up gets vaccinated and finally puts an end to the Pandemic of COVID.
4. There is a certain cruelty in choosing to not be immunized. As demonstrated, this choice clearly is a choice to keep the Pandemic going.  The cruelty comes in how that choice directly endangers the lives of everyone, but right not the key cruelty is the threat to the lives of every child unable to be COVID vaccinated today, namely all our children under 12 years old.
5.  To save your own life, get the COVID vaccine.
6.  To save the life of those you love, get the COVID vaccine.
7.  To save our children’s lives, get the COVID vaccine.
8.  To stop these updates, get the COVID vaccine.
9.  To stop a new variant that could kill us all, get the COVID vaccine.

My Takeaway in One Sentence:

History will long marvel that any group of people with a simple act that could stop the catastrophe of Pandemic widely available and free to all, chose Death- let us help history marvel at how our nation finally chose Life, and got the COVID vaccine.

To All Our Health,
Arthur Lavin MD