WE ARE NOW ACCEPTING NEW PATIENTS

Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

COVID-19 Update March 3, 2021: Danger Remains High, Relief May Be Coming; Is Our County Safe to Open Schools – CDC Has a Map; Rapid Home Testing the Coming Reality

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.

Danger Remains High, Relief May be Coming

Readers of Real Answers will already be familiar with the concept of this pandemic’s stages: Beginning, Middle, End.

The Beginning stage of the COVID-19 Pandemic was the time in which the virus simply spread, with little that could be done aside from isolating, to protect anyone.  That stage ended with the advent of safe, effective COVID vaccines, sometime late in 2020.

The Middle stage of the COVID-19 Pandemic is now.  This is the stage in which remedies are being put into practice that will end the Pandemic, but the virus still spreads, and anyone can still be killed by the spreading disease.

The End stage is when the virus stops spreading, lives no longer are at risk or lost, it is plainly put, when the Pandemic Ends.

We are not in the End, we are still solidly, tragically, in the middle.  As reported recently in Real Answers, even if we ramp vaccines up to 5 million doses a day in the US (we are nearing 2), and if everyone remains careful, we still will see 80,000 more of us die before the End of the Pandemic is achieved.  That is a best case scenario.  If we drop our guard, declare victory before the deadly danger ends, we could lose another 500,000 of our lives!

So the point of knowing the stages of the Pandemic sits with the choice, do we act to limit our deaths to 80,000, or let loose and condemn 500,000 to die?  The choice is right now in all our hands, how many will this virus take in our nation- 80,000 or 500,000?

Things We Can Do to Make the Pandemic End Sooner, and Save Hundreds of Thousands of Lives

There really are only 2 things we can do to save lives, and put this nightmare to bed.

Keep Away and Vaccinate.   Both do something very, very simple to understand- they stop this terrible virus from spreading to another person. Period.  We either do that or we don’t.  Period.

Keeping away means:

  • Do not gather*
  • Do not travel
  • Do not leave your home and if you do, wear a mask and stay 6 feet away from everyone else*
  • Stay away from ANY crowds
  • Avoid indoor gatherings especially*

Vaccinate means:

  • Do everything in your power to get vaccinated ASAP
  • As of yesterday, all those working in schools and pre-schools are priority and qualify for vaccination, now.

Things We Can Do To Make the Pandemic Stay and Lose the Lives of Another Half Million of Us

This is simple to state.   Anything any of us do to help the virus spread will keep the pandemic going and lead to massive numbers of more deaths.

A word on this spread.  We know of many, many instances where someone died from COVID after being in contact with someone who felt fine.

So for all our youth, and their parents, it is wonderful that if you get COVID you are likely to be fine, but if you get COVID, you can spread it, and it can spread to someone who may not survive it.

A simple list of easy ways to spread the virus and keep the killer pandemic going include:

  • Getting together with friends indoors*
  • Getting together with family indoors*
  • Travelling
  • Not wearing a mask
  • Not keeping distant
  • Joining crowds for any event

Recent News on Steps Taken to End and Steps Taken to Help Keep the Pandemic Going

Steps taken yesterday to END THE PANDEMIC:

  1. The supply of COVID vaccine is now officially exploding.  This is very, very, very big news.  It is now official that there will be enough vaccine for every adult in America to be fully vaccinated, by MEMORIAL DAY- that’s 89 days away.
  2. The nation has invoked the Defense Production Act, last really put into effect at large scale to win World War II.  This action now will provide to the US the following goods:
    • All the vaccine we need by summer.  We now see rivals Merck and J&J working together to blast production upward, I predict enough to put a huge dent in the pandemic around the world.
    • Tons of people and centers and places to give and to get the vaccine
    • Tons of PPE

Recent News on Steps Being Taken to Help the Virus Spread and Kill Many More People

The largest step taken in this direction was in one of our largest states, Texas.  It is now the official policy of the state of Texas, the state my Mom was born and where half my family lives, that no one has to wear a mask, and everyone is invited to pack nightclubs and bars, everywhere.   This is a surefire recipe to make sure this virus can once again spread like wildfire and kill vast numbers of people.  This is not a political issue.  The virus will infect liberals and conservatives very happily.

This step is dangerous for all of us, because right NOW, the virus is creating mutations that imperil all our hopes of ending the pandemic.  To let loose a massive spread across a huge area of massive numbers of people is the best path possible to breed a mutation that could threaten everyone of us around the nation and world, even those of us immunized.

The other step being taken is the Spring Rush.  It’s nice out.  The vaccine is rolling out, so why not just get together a little bit?

Here is why.  We have seen many cases of COVID, in babies, and adolescents, and adults, following one quick little get together.

*******

Did you notice the asterisk above?  It was there on purpose.  There is a get together that is now looking safe, that will not spread the virus, that you can do while still stamping out its spread.

That one exception is only for those who have completed a full series of COVID vaccine and waited for it to take effect.  Waiting means waiting 14 NOT 7 NOT 10 days after your LAST COVID vaccine.  For Pfizer and Moderna recipients that means after dose #2, and for Johnson and Johnson recipients that means after dose #1.

Only for those in this category, you may now gather, even indoors, even on the same sofa, even right next to each other, even without a mask, even with lots of hugs.  And, you will not be spreading the virus.

Now, keep in mind, this category, so far cannot include anyone under 16 years old, there is no one under 16 fully immunized for COVID.

To be clear, if 4 people are fully immunized and at least 2 weeks after completing their immunization sequence for COVID they can gather.  But their children cannot.

This window is very, very specific, wonderful, but specific.

It is not open because the virus is no longer spreading.  SARS-CoV-2 is spreading like wildfire even now.

We are thrilled numbers are dropping.  But all should know, this wonderful drop has stalled at a very dangerous level of about 70,000 new cases a day.  This is well under the peak of 240,000 that the holidays created.  So many feel, again with the nice weather, that all our troubles are over.  But again, we are in the Middle of this Pandemic, we are not at the End.  In fact, our current level of 70,000 cases a day, was the highest level of COVID in the United States of our whole Pandemic until the end of October, 2020!

We are not in a lull.

And so the only reason we gather safely now is the power of the vaccine.  NOT because the threat of the virus has dropped to anything like a safe level.  2,000 people died in the US yesterday, the threat remains, the threat is real.

Is Our County Safe to Open Schools- CDC has a Map

As we peer into a future that just might- if we keep away and if we vaccinate- see the Pandemic actually end, the prospect of schools opening fully to normal is coming nearer.

As posted before, under certain conditions, the CDC has ascertained that schools can open without risking spreading COVID.

Those conditions include a low level of COVID spread in your specific community, 6 foot spacing, universal mask wearing, and now the door opens to all adults being immunized.

Now, how do you know if your county qualifies and at what level of in-person?

Here are the numbers:

For full in-person learning- community rates cases of COVID need to be less than 50 per 100,000 people, and COVID test positivity rates less than 8%

For hybrid learning- community rates need to be 50-100 per 100,000 people, and COVID test positivity rates 8-10%

For remote learning, that is no one should be going to school in-person at all- any community with rates of COVID over 100 per 100,000 and COVID test rates positive over 10%.

Here is the CDC set of opening school guidelines- https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strategy.html

And here is a neat map by county of who is ready for full in-person, hybrid, or still needs remote only, for elementary and high school as of March 2, 2021:   https://www.nytimes.com/interactive/2021/03/02/us/covid-schools-reopen-cdc.html

Notice that Cuyahoga County does not yet meet CDC criteria for full opening of elementary or high schools, but does for hybrid opening of elementary schools.  The high school situation does not qualify for any in-person learning as of now. 

Rapid Home Testing, the Coming Reality

The FDA has approved of 3 companies’ home COVID testing kits, not just Ellume anymore, but now also Abbott and Lucira.  Keep your eye out for them going on sale.  They work well.  Negative tests are reliable, a positive test should be repeated and found positive to count on it.

Bottom Lines

  1. COVID-19 continues to spread at a terrible and alarming rate!  We are holding steady at 70,000 new cases a day, the highest number seen in the US from the start of the pandemic until last October 22.  It is better than during the holidays, but you can still catch COVID and lose your life to it, easily.
  2. As such we remain in the MIDDLE of the Pandemic, we are not at the End or near it.
  3. But the End may yet come, and in a few months even.
  4. Two steps need to be taken to reach the End:  Keep Away and Vaccinate.
  5. Keep Away means stopping the spread of the virus by not gathering, not travelling, wearing a mask, staying distant, staying away from crowds and indoors.  We know, everyone is doing these things, why can’t I?  Well, you can, but if you do, you will be joining many others in helping to keep the virus raging.
  6. If we think of the COVID Pandemic as a wildfire, the fire is not yet contained.  But we have the water (Vaccines) and actions (Keep Away) that can put the fire out.   But as we all know, it’s a very, very bad idea to spread the fire until the water and actions have really put it out. And once again, this Fire is NOT out.
  7. The news on vaccines is great.  The United States will have enough doses in hand for every adult in America by Memorial Day.  The good news is that this is only 89 days away.  The bad news is that this is still 89 days away.
  8. More good news from vaccines, if you are fullyvaccinated AND have waited 2 weeks after your final dose, you may gather with others in the same situation, indoors, closely, without masks.  That excludes all children under 16, and of course everyone who has not been fully immunized at least 2 weeks ago.
  9. The one piece of very bad news is that if you ignore the fact this virus is still spreading like wildfire, you can come to grave harm, as will tragically be demonstrated by Texas.
  10. Home COVID tests are coming near us soon, stay tuned. Once easily available, we can all test before work school or play and now we can do so safely.

My Takeaway – In One Sentence:

Good news is coming, but is not here yet- we all have to stay careful for a few more months to reach the End, or risk a Redo.

To your health,
Dr. Arthur Lavin

 

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