Coronavirus updates February 2021...please add yours.

[missy]

Am I understanding correctly that it has not been determined that a COVID vaccine prevents transmission and it also hasn’t been proven that it keeps someone vaccinated from catching COVID? In this interview she says “in the event that they prevent COVID”. The WHO said the same in December and Fauci himself said this just last week.

They keep on talking about herd immunity but there won’t be herd immunity if the vaccines don’t prevent transmission of the virus.

We don’t know yet (too soon) if it helps prevent transmission. It probably does help decrease it imo. But time will tell. And the Pfizer and Moderna vaccines are up to 95% effective in preventing infection after one has received both doses and two weeks from the second dose have passed. I’m talking in general terms only. YMMV. It’s very early to make any concrete conclusions. The answer is time will tell.

 

[missy]

"

Why Japan’s vaunted health system faltered​

Throughout the coronavirus pandemic, officials in Japan continuously warned about the prospect of its medical system collapsing if infections got out of control. During a recent winter surge of cases, that appeared to come true. Reports of hospitals near capacity and deaths from mild infections in quarantine colored the local news. The national government had to send in medics from the Self-Defense Forces to certain areas to help overwhelmed doctors. A state of emergency was extended recently, despite falling infection numbers, because of the insecurity of the health system. Still, coronavirus case numbers in Japan remained a fraction of those seen in Western countries . Having covered the state of Japan’s health-care system — whose only fault in the past seemed to be that it helped nurture such long lives that it was costing the public purse way too much — I was puzzled by this disconnect. So were many Japanese residents. Shuttered restaurants in Tokyo. Photographer: Carl Court/Getty Images AsiaPac How could one of the world’s most resource-abundant health systems, with the highest number of hospital beds, MRI machines and CT scanners per capita in the OECD, and occupying the highest decile in the Universal Health Coverage index, be faltering under Covid-19? It turns out, the usual strengths in Japan’s health system worked against it. The system is dominated by private hospitals focused on preventative and general care. During normal times, the competition among hospitals means better services for patients and a healthier population. But during a pandemic, it means lack of coordination and not enough specialist physicians for acute care or infectious disease. Such a system also lacked flexibility to adapt quickly -- while in the European Union, patients and resources were moved across country borders, in Japan it was difficult to do that between prefectures. So while some urban areas were overwhelmed, hospital beds for Covid patients in other areas stood empty. There are many sides to health care, and having a good system that offers fast and affordable treatment typically doesn't make it better prepared for an emergency. It’s just one of the many contradictions the Covid-19 pandemic has unveiled.--Lisa Du"

The Path to Immunity Around the World​

Our vaccine tracker allows you to see when various locations will likely reach herd immunity. The U.K. is rushing to hit a target of offering 15 million people their first vaccine shot by mid-February. Meanwhile in Canada, at the current rate, it will take an estimated 6.4 years to cover 75% of the population with a two-dose vaccine. That's down from last week, when Canada's inoculation rate put it at more than 10 years.

 

[missy]

On Variants FYI.



"
Viruses mutate all the time, including the novel coronavirus that’s caused the global Covid-19 pandemic. Most of the changes have no apparent effect. But recent variants that have emerged in the U.K., South Africa and Brazil are causing particular concern. Studies suggest they are more contagious, and some evidence points to the U.K. strain being more deadly. An increase in infections has led to a surge in hospitalizations and deaths in England, Portugal and elsewhere. Vaccine developers are working on new versions after early data from South Africa indicated AstraZeneca Plc’s inoculation was less effective against the variant circulating there.

1. What’s a variant?​

During replication, a virus often undergoes genetic mutations that may create what are called variants. Some mutations weaken the virus; some have no impact. But, if they confer some advantage, then that variant is going to proliferate. Variants with distinctly different physical properties, or “phenotypic characteristics,” may be co-termed a strain. Variants that deviate significantly from their viral ancestors may be designated as belonging to a new lineage, or branch on the evolutionary tree. In general discourse, however, the terms are often used interchangeably.

2. How widespread is this?​

The variant that emerged in southeast England in September, dubbed the B.1.1.7 lineage, contributed to a surge in cases that sent the U.K. back into lockdown in January. Other countries have followed, particularly in Europe. Australia’s Victoria state imposed a five-day lockdown in mid-February when it appeared to be spreading there. In the U.S., health officials have warned the strain could become dominant as soon as March; President Joe Biden toughened rules in his first days in office to try to contain it. In southern Africa, hospitals are facing pressure from a resurgence driven by another variant, 501Y.V2 (also known as B.1.351). Brazilian researchers are warning that a so-called P.1 variant spotted in Manaus, Amazonas state, in December may have driven a surge in cases that strained the health system and led to oxygen shortages. Researchers at Cedars-Sinai Medical Center in Los Angeles reported a novel strain, denoted as CAL.20C, linked to a surge of coronavirus cases in Southern California, though less is known about its effect on infectivity and disease severity. Insufficient surveillance in most countries, including the U.S., has left the world blind to the variantscirculating in many places.

3. How serious is it?​

Researchers at the London School of Hygiene and Tropical Medicine found the B.1.1.7 variant was associated with a 30% greater risk of death, possibly due to its propensity to replicate, resulting in a higher viral load. In absolute terms, however, the risk is still small: A male aged 55–69 years had a 0.73% chance of dying within 28 days of testing positive for the variant, compared with 0.56% risk of death if his SARS-CoV-2 infection was caused by a different strain, the researchers said in a study released ahead of peer-review and publication. Public Health England in February noted emerging evidence of an additional mutation in the B.1.1.7 variant that may weaken any immune protection gained from current vaccines or naturally from a previous infection with an earlier strain. Less is known about the other variants.

4. Do the new variants cause different symptoms?​

Some subtle differences have been noted in symptom patterns among U.K. patients infected with the B.1.1.7 variant compared with other strains. The former are more likely to have a cough, sore throat, fatigue or myalgia, according to a report in the BMJ. Data from the U.K. Office for National Statistics indicate people with the new variant there are less likely to experience losing the sense of smell or taste. The findings prompted some doctors to call for the official Covid-19 symptom list to be reviewed and potentially expanded for the first time since May.

Manifesting a Variant​

Sore throat, fatigue and muscle aches are more common with U.K. variant

5. How quickly have the strains spread?​

Rapidly, aided by year-end holidays that are traditionally associated with increased family and social mixing. As of Feb. 2, imported cases or community transmission of the B.1.1.7 variant from the U.K. had been reported in 80 countries, according to the World Health Organization. Scientists estimate that B.1.1.7 is doubling in the U.S. every 10 days, with at least a 35-45% higher transmission rate than previous strains. Similarly, scientists have found the 501Y.V2 variant that was first detected in Nelson Mandela Bay, South Africa, in early October is about 50% more transmissible than earlier versions. It has led to a steep rise in cases across southern Africa as well as the Seychelles and Mauritius. As of Feb. 2, 501Y.V2 had been identified in 41 countries, while 10 countries are reported to have detected the P.1 variant first seen in Brazil, according to the WHO.

6. How are the variants increasing transmission?​

They appear to have some advantage over other versions that has enabled them to quickly predominate, although factors such as people congregating indoors more in colder weather may also contribute to spread. The U.K. strain has acquired 17 mutations compared to its most recent ancestor -- a faster rate of change than scientists typically observe. A U.K. advisory group said in December that the B.1.1.7 lineage may result in an increase in the basic reproduction number, or R0 (the average number of new infections estimated to stem from a single case) in the range of 0.39 to 0.93 -- a “substantial increase.”

7. How many mutations are there?​

Many thousands of mutations and distinct lineages have arisen in the SARS-CoV-2 genome since the virus emerged in late 2019. A variant with a so-called D614G mutation emerged in early 2020. By June, it had replaced the initial strain identified in China to become the dominant form of the virus circulating globally. Months later, a novel variant linked to farmed minkwas identified in a dozen patients in North Jutland, Denmark, but doesn’t appear to have spread widely. As mutations continue to arise, they will lead to more new variants.

8. Are some mutations more important?​

Yes. Scientists pay most attention to mutations in the gene that encodes the SARS-CoV-2 spike protein, which plays a key role in viral entry into cells. Targeted by vaccines, this protein influences immunity and vaccine efficacy. The B.1.1.7, 501Y.V2, and P.1 variants all carry multiple mutations affecting the spike protein. That raises questions about whether people who have developed antibodies to the “regular” strain -- either from a vaccine or from having recovered from Covid-19 -- will be able fight off the new variants.

9. What do we know so far?​

In January Public Health England found those previously infected with the “regular” coronavirus are likely to mount an effective antibody response against the B.1.1.7 variant. But the same month the first known instance of a recovered Covid-19 patient being reinfected with the P.1 variant was reported in Brazil. That strain has several key mutations in common with the 501Y.V2 strain from South Africa. In a Jan. 28 editorial in the Journal of the American Medical Association, virologist John P. Moore and vaccinologist Paul Offit described the 501Y.V2 variant as more “more troubling” because of its potential for reducing vaccine efficacy, due to its particular spike-protein mutations.

10. So how effective will vaccines be?​

Moore and Offit’s concerns appear well founded, with clinical trials of candidate shots from both Novavax Inc. and Johnson & Johnson showing lower efficacy in South Africa compared to other countries. Although vaccines studied in late-stage clinical trials appear effective at preventing severe disease in the majority of participants, there is emerging evidence that some may not be as good at stopping less-severe illness. South Africa announced plans in early February to halt its rollout of the AstraZeneca vaccine after preliminary data suggested the shot “provides minimal protection” against mild disease caused by the variant circulating there. However, a WHO advisory panel reviewing the AstraZeneca vaccine said that study had limitations, including its size and focus on low-risk participants, and it used interval doses that weren’t optimal for inducing immunity. There is also no data to determine the extent to which immunization will prevent asymptomatic infection and transmission of SARS-CoV-2, including the new strains.

11. Will some vaccines be more protective?​

Most likely. Although there have been no clinical studies directly comparing different types and their ability to protect against the new strains, lab studies have indicated that the so-called mRNA vaccines from Moderna Inc.and Pfizer Inc.-BioNTech SE may be more effective than other types. Scientists at the Fred Hutchinson Cancer Research Center in Seattle found a single jab of either the Moderna or Pfizer-BioNTech shot bolstered the immune response in 10 patients who had recovered from a SARS-CoV-2 infection early in the pandemic. The concentration of neutralizing antibodies in the recipients’ blood increased about a thousand fold, and they appeared potent against the South African variant.

12. What are drugmakers doing?​

Sarah Gilbert, a professor of vaccinology at the University of Oxford who conducted the initial research on the AstraZeneca vaccine, said that “efforts are underway to develop a new generation of vaccines that will allow protection to be redirected to emerging variants as booster jabs, if it turns out that it is necessary to do so.” The new shot could be ready for the fall, she told the BBC. Pfizer and its German partner BioNTech, as well as Moderna, have said their own results indicate their vaccines should still work against the strain detected in South Africa, despite the reduced potency. Nevertheless, Moderna said it plans to develop and test a third-shot booster against that variant, and Pfizer’s chief executive officer also said his company is starting the development of a booster against the new mutations. Novavax said it started working on new versions of its vaccine targeting the emerging strains in January and expects to select ideal candidates for either a booster or combination shot. Such alterations aren’t unheard of -- it happens annually with seasonal flu, which evolves quickly. Unlike flu, coronaviruses have a genetic self-correcting mechanism that minimizes mutations.

13. Could different vaccines be used in combination?​

Potentially, yes. The Coalition for Epidemic Preparedness Innovations, or CEPI, announced in January up to $140 million in funding for additional clinical research to optimize and extend the use of existing vaccines. This could include “mix-and-match” studies of different shots used in combinations that may improve the quality and strength of the immune response. Such studies could be useful in optimizing the use of available inoculations, including the AstraZeneca shot, according to the WHO.

14. Are there any other implications?​

Yes, treatments and diagnostics could be affected. Researchers in South Africa found a theoretical risk that some antibodies being developed for therapeutic use could be ineffective against the 501Y.V2 variant prevalent there. But studies at Columbia University support tests by Regeneron Pharmaceuticals Inc. showing that its antibody cocktail, which was granted emergency-use authorization in the U.S. and administered to Donald Trump, is effective at neutralizing 501Y.V2 and the variant first identified in the U.K. Drugmakers are using combinations of antibodies that target separate features of SARS-CoV-2 to decrease the potential for so-called virus-escape mutants that could emerge in response to selective pressure from a single-antibody treatment. The U.S. Centers for Disease Control and Prevention has said new strains might undermine the performance of some PCR-based diagnostic tests. The impact, though, isn’t likely to be significant, according to the World Health Organization.

"

 

[missy]

300M Doses Pledged by July; Trump Had It Bad; NY's Nursing Home Cover-Up

A daily roundup of news on COVID-19 and the rest of medicine

www.medpagetoday.com

"
With a new deal finalized, President Biden said there will now be enough doses to vaccinate 300 million Americans by the end of July. (The Wall Street Journal)

NIAID Director Anthony Fauci, MD, predicted all adults could begin getting their shots by April. (CNN)

As of 8:00 a.m. ET on Friday, the unofficial COVID-19 toll in the U.S. reached 27,393,896 cases and 475,457 deaths -- up 105,606 and 3,693 respectively, since this time yesterday.



People close to President Trump are spilling the tea on his bout with COVID-19; he was allegedly in much worse shape than previously disclosed. (New York Times)

In available data from 27 states, more than a third of people 65 and older already received their first jab. (AP)

But to help with vaccine inequities, the Biden administration is partnering with community clinics to reach underserved populations. (NPR)

AP obtained documents showing just how many recovering COVID patients in New York were sent to nursing homes last spring. It's a much bigger number than officials reported earlier.

And an aide to Gov. Andrew Cuomo (D) admitted to covering up the state's actual nursing-home death toll out of fear of a federal investigation. (New York Post)

It's not just the Empire State: 4,000 COVID-19 deaths went unreported in Ohio, where the health department promises an investigation and internal overhaul. (AP)



The latest update to the NIH treatment guidelines now includes trial data on ivermectin.

New data pinpointed that the Southern California variant -- CAL.20C -- is defined by three mutations in the S-protein, but effects on disease severity or infectivity remain unclear. (JAMA)

Proto-goth rocker Alice Cooper, 73, got a COVID vaccine despite having already been infected. (Billboard)

Disruption at the Australian Open tennis tournament as its host region goes into a 5-day lockdown. (ESPN)



"

 

[Daisys and Diamonds]

My apologies if this has already been posted
But its nice !

Covid-surviving nun, world's second-oldest person, celebrates 117th birthday in style

A birthday feast and a special Mass were planned today for Sister Andre's celebration in France.

www.tvnz.co.nz

 

[missy]

https://www.nejm.org/doi/full/10.1056/NEJMms2101220

"
On September 8, 2020, AstraZeneca announced that it was pausing its late-phase SARS-CoV-2 vaccine trial because of a serious adverse event in a U.K. participant. The next day, my hairdresser, Ms. J., asked me what I thought about the news. I said the halting of the trial to investigate the adverse event was reassuring — an example of science doing its job. “What do you think?” I asked.
“There’s no effing way I’m getting a vaccine,” she said.

Ms. J., who lives in New York City, had Covid-19 in April. Though she didn’t require hospitalization, the virus incapacitated her for weeks, leaving her weak and unable to tolerate solid foods; for months, she continued to become dyspneic with exertion. She was terrified of getting the virus again and derived little comfort from the possibility that she had enduring immunity. Yet the prospect of getting a Covid-19 vaccine was even scarier. Emphasizing the haste of vaccine development, the need for long-term safety data, and concern that side effects could “make everything worse than it already is,” Ms. J. added that most of her friends and relatives were similarly “really suspicious” of the vaccines.
And they are not alone. Though many people initially believed a vaccine was the magic bullet that would save us from a devastating pandemic and return our lives to normalcy, we now find ourselves contemplating simultaneously how to ethically allocate a limited number of vaccine doses to the many people who want them and how to increase vaccine uptake among those who don’t. Though estimates vary, public health officials suggest that about 80 to 85% of Americans would need to be vaccinated for the country to achieve herd immunity. Vaccine confidence seems to be rising, but recent polling suggests that about 31% of Americans wish to take a wait-and-see approach, and about 20% remain quite reluctant.1 The behavioral obstacles to widespread vaccination are thus as important to understand as the scientific and logistic hurdles.
Accordingly, since September, I have been talking with people about their perceptions and concerns about Covid-19 vaccination. Before the election, people often mentioned the prospect that a vaccine would be approved prematurely by a desperate Trump administration, but concerns about long-term safety are common, persistent, and not unfounded. Even though adverse events tend to occur within the first 6 to 8 weeks after vaccination, vaccines are typically not approved until 2 years of follow-up data have been gathered. In addition, some SARS-CoV-2 vaccines, such as those based on messenger RNA, use new technologies for which long-term data are lacking. We also don’t yet know the durability of immunity, the degree to which vaccines prevent asymptomatic infections, or whether boosters will be necessary, especially given the emergence of viral variants. In the midst of a pandemic that is taking thousands of lives daily and devastating society, many people will find these uncertainties acceptable. But for others, as with many trade-offs in medicine, the magnitude of benefit may have less emotional resonance than the possibility, no matter how minimal, of risk.

More Than Messaging​

For those with intent to be vaccinated, interventions such as default appointments and onsite vaccination effectively increase uptake.2,3 Less is known, however, about how to increase uptake by modifying the beliefs of the hesitant. In one randomized trial targeting parents with children eligible for the measles–mumps–rubella (MMR) vaccine, researchers tested various messaging strategies that either corrected misinformation or had emotional appeal. One strategy refuted the claim that vaccines cause autism, while others featured pictures of children with the diseases the MMR vaccine prevents or a dramatic narrative about an infant who nearly died of measles.4
These strategies not only failed to increase intent to vaccinate, but among vaccine skeptics, they actually did the opposite. Graphic pictures of a child with measles increased fears of vaccine-related side effects rather than fear of the disease itself. And though accurate information reduced the misperception that vaccines cause autism, intent to vaccinate still decreased among the most hesitant parents. Extrapolating these findings to a paralyzing pandemic comes with countless caveats, foremost among them that vaccination will initially target adults. Nevertheless, as we embark on far-reaching messaging campaigns, some humility about our intuitions about human behavior is in order.
We do know that the confidence of physicians and public health officials can be instrumental in allaying people’s fears.2 One elderly couple I spoke with in October, for instance, after expressing reservations about a vaccine being approved prematurely for strictly political reasons, concluded, “If Anthony Fauci approves it, we will go for it.” This sentiment is consistent with what we know about vaccine uptake in general: the seemingly most effective way to increase vaccination rates is with clinician recommendations.2,5 As Robert Jacobson, a Mayo Clinic pediatrician who studies vaccine hesitancy, pointed out, since health care workers are among the first groups to be vaccinated, they will be able to speak to their patients with authority and confidence: “I got this vaccine, and I want you to have it, too.”
As critical as recommendations from trusted authorities will be, in an environment rife with misinformation and distrust of expertise, disseminating evidence-based information may be insufficient to persuade some people. That’s partly why Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine whose recent book, Stuck, summarizes her decades of research on vaccine hesitancy, sees Covid-19 as an opportunity to rethink our approach to vaccine uptake. Larson, who studies rumors, cautions against the impulse to merely correct misinformation and assume our work is complete. Writing before the pandemic, Larson observed that “Vaccine reluctance and refusal are not issues that can be addressed by merely changing the message or giving ‘more’ or ‘better’ information.”6 Though the pandemic has cast the dangers of misinformation into stark, soul-crushing relief, the gravity of a falsehood’s consequences doesn’t render it more correctable with truth.
Larson’s own thinking was transformed in 2003, when, while overseeing vaccine strategy and communication at UNICEF, she was called to Nigeria, where a government-led boycott of the polio vaccine was under way. There, Larson discovered that resistance reflected not specific concerns about the vaccine but rather a convergence of broader social factors, including rumors that Western vaccines were intended to sterilize children; a fear, in the aftermath of 9/11, that the United States was at war with Muslims; and ongoing conflict between the local and central governments. Quashing the rumors seemed to matter less than addressing the nexus of questions, concerns, beliefs, and historical forces that gave rise to them. Though the reasons for skepticism may vary among communities, Larson’s approach to vaccine hesitancy is universally relevant: before you attempt to persuade, try to understand.

The Undecideds​

Mr. K. is a 56-year-old man who avoids vaccines and decided with his wife not to vaccinate their children. “People disregard you as a conspiracy theorist,” he told me, “but we put a lot of thought into making that decision.” Many of Mr. K.’s beliefs were informed by his father-in-law, a pediatrician who has concerns about the safety of vaccines. “He is not a pharma-driven doctor,” Mr. K. explained. “He’s not part of the medical establishment.” The problem with that establishment, as Mr. K. sees it, is not just its drug pushing and profiteering, but its censoring of people who disagree. For instance, in July, when social media companies removed a viral video of physicians suggesting (misleadingly) that hydroxychloroquine was an effective treatment for Covid-19, Mr. K. saw a parallel to attempts to quash antivaccine sentiment. “What is going on with this country where people can’t make their own decisions?” he asked. “I try to find the scientists out there who aren’t afraid of losing a grant — people who have nothing to lose if they speak the truth.”7,8
In both his aversion to mainstream medicine and his perception that people questioning medical dogma are censored, Mr. K. highlights a Catch-22 of vaccine hesitancy: by challenging untruths, we may inadvertently feed the perception that the “real” truth is being suppressed. Larson describes in her book the fallout after pressure from the scientific community resulted in removal of the antivaccination film “Vaxxed” from the Tribeca Film Festival in 2016. The pulling of the film confirmed the belief of vaccine doubters that physicians and scientists are unwilling to engage with any dissent. Moreover, notes Larson, these instances of so-called censorship attract people who, while not necessarily antivaccine, identify with broader rights agendas promoting “freedom” and “a fundamental democratic right to choose.”6
Indeed, while people firmly opposed to all vaccines may be relatively few in number, they wield outsized influence, particularly on social media, over the undecideds. A recent study of expressions of vaccine-related sentiments by 100 million Facebook users found that antivaccine clusters of people, though less numerous than provaccine clusters, have a more central presence in large networks and interact with more undecided clusters.9 Provaccine clusters, meanwhile, engage predominantly in smaller networks, so even though they exert less influence, they often have the “wrong impression that they are winning.” Provaccine clusters are also disadvantaged by the tendency toward “monothematic” messaging, whereas antivaccine pages deploy multithemed narratives to broaden their appeal, touching on safety concerns, alternative medicine, Covid-19 (both causes and cures), and various conspiracy theories. In response to these dangerous disinformation campaigns, social media companies have intensified efforts to label falsehoods and eliminate them. But as Neil Johnson, a physicist and the study’s first author, explained to me, such efforts can backfire.
One of the most widely shared Covid conspiracy theories, for example, is that the vaccines contain microchips that will be used by elites (Bill Gates is often mentioned) or by the government to track people’s behaviors. People propagating the rumor often point to a study of a new technology that delivers microparticles intradermally during vaccination, creating a digital vaccine record.10 The research, funded by the Gates Foundation before Covid, aims to address the challenge of vaccine record keeping, particularly in low-resource countries. Although this technology is not present in any Covid vaccine, Johnson, who has been monitoring vaccine sentiment online throughout the pandemic, cautioned against dismissing the rumor as mere misinformation. “We can hope that Bill Gates won’t eventually use it to track Covid vaccine behavior, just like we hope our neighbors won’t one day wake up and plow their car into our house,” Johnson said. “They could in principle, but it’s highly unreasonable to think that they would.” If the vaccine hesitant feel that they’ve been unfairly accused of spreading misinformation, Johnson explained, they become further emboldened in their doubts. Even ideologically disparate groups unify around such shared skepticism.
Johnson’s observations remind us why teaching the public to “understand science,” the seemingly obvious way to mitigate antiscientific sentiment, may fall short. Many discussions about science denialism conclude with some version of “We just need to get the public to understand science.” But evidence suggests otherwise. Sociologist Gordon Gauchat, for instance, in describing temporal trends in distrust in science, has shown that at least among conservatives, it’s the most educated subgroup who have become increasingly skeptical.11 One possible explanation is that highly educated people are more facile at finding evidence to support their views or in poking holes in evidence that doesn’t. Accordingly, in a 2019 essay on the so-called crisis in truth, in which antivaccine sentiment features prominently, history-of-science professor Steve Shapin makes the surprising argument that there isn’t “too little science in public culture,” but “too much.”12 That’s partly because people who deny climate change or reject vaccines co-opt the language of science to bolster the legitimacy of their views. Their arguments, Shapin writes, are often “garnished with the supposed facts, theories, approved methods, and postures of objectivity and disinterestedness associated with genuine science.”
Where do these bleak observations leave us as we seek to raise confidence in Covid vaccines?

From Stigma to Empathy​

As the pandemic has sharpened the polarization over science, disdain for science denialism has made it easy to conflate true antiscientific sentiment with simple fear of the unknown. In my many conversations about vaccines, what struck me most was the shame that often preceded any expression of doubt. Some people simply refused to talk to me; others, particularly those who work in health care, were skittish about being identifiable. And those who had questions often prefaced them with “I’m not an antivaxxer but….” One common question, for instance, was whether people who are young and unlikely to die of Covid should get a vaccine whose long-term side effects are unknown.
My instinctive response to this sort of question is to emphasize the population benefits of vaccination and the reality that some young people do die from Covid and that even survivors may have long-term sequelae we don’t fully understand. But why not simply acknowledge the legitimacy of the concern? For many of us in the medical community who are haunted by the consequences of science denialism, validating any aspect of vaccine skepticism may feel like ripping your mask off in a crowded elevator. But it isn’t “antiscience” to admit that we still don’t know some things. It’s just truth.
Nevertheless, among people who take no solace in rigorous science, more than transparency will be needed to build trust. Larson notes how quick the scientific community is to justify medical recommendations by saying, essentially, “Science said so.”13 Referring to the pausing of the AstraZeneca trial due to an adverse event, for instance, Larson notes how much of the media coverage featured scientists noting the “normality” of pausing a trial to investigate any adverse events. To Larson, though, this response lacked expressed empathy for the person(s) who experienced an unexpected reaction. “It’s not normal for the person who was hurt,” she said. In our rush to defend the vaccine and the evaluation process, the scientific community may fail to convey how the participant’s symptoms were addressed, though it’s the latter — more than fidelity to science — that may be foremost on people’s minds. After speaking on the radio about this oversight, Larson was contacted by a trial participant who’d experienced an adverse event and wanted Larson to know how well she’d been cared for by the trial’s clinicians. “The scientists were doing the right thing,” Larson told me, “but they weren’t communicating it.”
Of course, people who are determined to undermine confidence in vaccines will always find ways to spread misinformation. But a much larger proportion of the population may be willing to get vaccinated given the proper reassurances, and dismissing their concerns often leaves them seeking someone to validate them. I suspect that’s one reason why correcting misinformation often falls short. Some people, for instance, may truly believe that vaccines cause autism. But for others, this ostensible fear may mask less easily expressed needs such as maintaining one’s identity, belonging to a group, or simply being heard. And yet respecting these more basic instincts also raises an uncomfortable question: At what point does empathy sacrifice scientific truth?
Or perhaps this is a false dichotomy. One of my best friends practices in a region where many people, including some health care workers and patients in her practice, are hesitant to get vaccinated. Even my friend — whose brilliance and rationality I have always admired — has reservations about vaccination, though she knows that expressing them is taboo. But I think that it’s only because she understands why people are scared that she’s effective not just at allaying fears, but at convincing people who don’t know anyone who’s willing to get vaccinated that what is known about the vaccine is more important than what isn’t. Indeed, the staff members who were initially reluctant to be vaccinated, changed their minds after speaking with her.
Although the scientific community’s obligation will always begin with championing truth, the pandemic has shown that society’s health also depends on understanding why so many people reject it. While some trust scientific experts, Larson notes that others seek “truth” elsewhere — their experiences, perhaps, or “heard truths” from their social networks. The pandemic, then, has reminded Larson why getting the public to understand science may be insufficient.14 Maybe, she suggests, it’s also time for science to understand the public.
This article is Part 1 in a two-part series. Next week: “No Cure without Care — Soothing Science Skepticism.”
"

 

[missy]

https://www.nejm.org/doi/full/10.1056/NEJMe2035557

Snip

"Although the Covid-19 pandemic is currently raging, the prospects for control of this and future pandemics are bright. The recent FDA issuance of EUAs for these extraordinarily protective vaccines provide us with much-needed hope at a time when so many are suffering. The next challenge is to get these and the next Covid-19 vaccines to the people most at risk as quickly as possible."

https://www.nejm.org/doi/full/10.1056/NEJMoa2035389

Snip...


"The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427. opens in new tab.)"

 

[missy]

Wow.

New mammogram guidelines for women recently vaccinated for COVID-19

Women should get their mammogram before their first dose of the vaccine, or four weeks after their second dose

www.fox13now.com

“
They say women who recently received a COVID-19 vaccine may have to postpone their yearly mammogram.

“When one receives a vaccination there is an inflammatory response in the arm,” said Dr. Brett Parkinson, medical director of Intermountain Healthcare’s Breast Care Center.

In the past four weeks, doctors have seen swollen lymph nodes on screening mammograms of women who have recently been vaccinated.


Whenever we see these on a normal screening mammogram we call those patients back because it can either mean metastatic breast cancer which travels to the lymph nodes or lymphoma or leukemia.”

While inflammation is the body’s normal response to a vaccine, Dr. Parkinson says it’s surprising how many swollen lymph nodes they’ve been seeing.

“With the Moderna vaccine it’s about 11% after the first dose and 16% after the second dose. We believe it’s comparable for the Pfizer vaccine as well.”

In response, Intermountain rolled out new guidelines in accordance with the Society of Breast Imaging.

Women should get their mammogram before their first dose of the vaccine, or wait four weeks after their second dose of the vaccine.

“We don’t want these patients to get a false positive to have this sort of alarm,” Parkinson said.

If there are worrisome symptoms, such as a suspicious lump, Dr. Parkinson says don’t delay getting a mammogram.”

 

[MaisOuiMadame]

Unfortunately there have now been several cases reinfection and notably one person on a ventilator (in Paris) who had an infection in 2020 and now has a more severe case due to the South African variant.

Source in French

https://www.lepoint.fr/sante/covid-...ariant-sud-africain-12-02-2021-2413778_40.php

I'm afraid the herd immunity theory is even less an option than the vaccination route.

I officially hate this virus!!

Am I understanding correctly that it has not been determined that a COVID vaccine prevents transmission and it also hasn’t been proven that it keeps someone vaccinated from catching COVID? In this interview she says “in the event that they prevent COVID”. The WHO said the same in December and Fauci himself said this just last week.

They keep on talking about herd immunity but there won’t be herd immunity if the vaccines don’t prevent transmission of the virus.

 

[missy]

Unfortunately there have now been several cases reinfection and notably one person on a ventilator (in Paris) who had an infection in 2020 and now has a more severe case due to the South African variant.

Source in French

https://www.lepoint.fr/sante/covid-...ariant-sud-africain-12-02-2021-2413778_40.php

I'm afraid the herd immunity theory is even less an option than the vaccination route.

I officially hate this virus!!

Scary. Hoping the vaccines help against the variants.

 

[MaisOuiMadame]

France has suspended use of the Astra Zeneca vaccine in several regions due to severe side effects.


ETA a source: https://www.leparisien.fr/societe/s...ter-12-02-2021-NAASFVX3WNCFHBKTZPRELS7D6M.php

To be more accurate:
The hospitals suspended the use for their staff, because the ratio of moderate size effects (high fever, flu symptoms) was so high that the hospitals were non functional from lack of staff.

3 of my doctor friends refused the AZ vaccine because of the technique used - apparently the viral vector approach does raise some concerns that haven't been publicly discussed at all ( in Europe).



Not great news..

 

[MaisOuiMadame]

Scary. Hoping the vaccines help against the variants.

It seems to look like it, fortunately

 

[missy]

Rise of Variants Sparks Push for All-in-One Covid Vaccines

Just weeks into the rollout of vaccines to combat Covid-19, researchers are shifting their focus to a new class of potential shots to take on the threat posed by fast-spreading mutations.

www.bloomberg.com

"
Pfizer, Moderna and Johnson & Johnson have said they’re starting work on developing booster shots or other efforts to bolster their vaccines. AstraZeneca and partner University of Oxford aim to have a tweaked version tailored to new variants available by fall.

One problem drugmakers confront in the quest for a single shot that covers different strains is that they don’t yet know which ones will be the most prevalent in the months to come, according to Andrew Pollard, the lead investigator on the Oxford trials.

“We know today which ones you would choose, but the virus is likely to continue to evolve under pressure from human immunity and so that could change over time,” he said.

For years, multivalent flu vaccines targeting three or four versions of the pathogen have provided protection against multiple strains circling the globe. Glaxo and CureVac plan to rely on mRNA technology to develop a product that addresses multiple variants in one Covid vaccine. If the work is successful, a vaccine could be ready next year.

Some scientists, including a team at the University of Cambridge, are exploring vaccines that could protect against multiple coronaviruses to prepare for future pandemics. Backed by U.K. funding, the Cambridge group is developing technology that could be plugged into any platform to fight multiple variants and other coronaviruses, such as Middle East respiratory syndrome, or MERS. They’re planning to start human trials in the spring.

As the work progresses, the pressure is rising. New strains could make it more difficult to achieve a sufficient level of immunity needed to get control of the virus.—James Paton and Suzi Ring"

 

[missy]

Pfizer update:


"
It's critical to get the 2nd shot!
You may only get about 52% protection between the first and second shot but 94% to 95% after the second. Come back about 21 days later for Pfizer and 28 days later for Moderna second doses (while the second dose should be given as close to this recommended interval as possible, it's okay to get it up to 4 days early or up to 6 weeks after the first dose. Even if you miss the extended interval, you should still get your second shot, although you'll have less protection during that time).


Second dose efficacy
Analysis of data from Israel among more than 1.7 million people who received both doses of the Pfizer vaccine estimated the vaccine's effectiveness in preventing severe disease to be in the range of 87% to 96%. To prevent SARS-CoV-2 positive cases (that is, any level of disease), its effectiveness was in the range of 66% to 85%. This shows that a significant number of infections can still occur, although few will be severe. Vaccine effectiveness was somewhat greater among those younger than 60 than among older people

• Be prepared for side effects, especially after the 2nd shot
  Injection site pain (typical for any vaccine) and flu-like symptoms are the most common side effects for both the Pfizer and Moderna vaccines. These side effects are typically short-lived and not severe.
• The vaccine takes about 7 days to work after the 2nd shot
  Don't assume you're protected from COVID-19 immediately after receiving the second shot, and certainly not during the 21 to 28 days between the first and second shot.
• Even after being fully vaccinated, for now, continue to follow guidelines for social distancing and wearing masks.

"

 

[missy]

Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC

Find interim clinical considerations for the use of COVID-19 vaccines for the prevention of coronavirus disease 2019 (COVID-19) in the United States.

www.cdc.gov

 

[Matata]

Here's one more aspect of this virus to add to the domino effect:

'A tragic case:' Organ transplant patient dies after receiving Covid-infected lungs

First proven case in the U.S. in which the virus was transmitted via an organ transplant prompts calls for more thorough testing of donors.

www.nbcnews.com

 

[TooPatient]

Today is February 22. This is officially one year to the day since DH and I flew to a convention with my cousin and grandfather. I was a bit tired during the day, but mostly okay until we got home that evening. I was hit with the worst chills and deep body ache as soon as we walked in the house. I don't remember ever having such miserable deep chills before. The entire next week was just too fatigued and sick to remember. DH started to be tired a little less than a week later and then the chills and body aches hit him. I was miserable and barely functioning until somewhere around May. DH was out of work for just short of six months followed by a slow ramp up to full time over the next several months.

How are we now? I am okay. I have MS and many of the issues that are considered part of long COVID are part of my normal day. DH is still dealing with shortness of breath, fatigue, focus issues, random pains, and an assortment of other issues that seem to be neurological based on how similar they are to what I deal with.

 

[missy]

Update so good I had to share twice.

Pfizer-BioNTech Shot Stops Covid Spread, Israeli Study Shows

www.bloomberg.com

 

[missy]

Today is February 22. This is officially one year to the day since DH and I flew to a convention with my cousin and grandfather. I was a bit tired during the day, but mostly okay until we got home that evening. I was hit with the worst chills and deep body ache as soon as we walked in the house. I don't remember ever having such miserable deep chills before. The entire next week was just too fatigued and sick to remember. DH started to be tired a little less than a week later and then the chills and body aches hit him. I was miserable and barely functioning until somewhere around May. DH was out of work for just short of six months followed by a slow ramp up to full time over the next several months.

How are we now? I am okay. I have MS and many of the issues that are considered part of long COVID are part of my normal day. DH is still dealing with shortness of breath, fatigue, focus issues, random pains, and an assortment of other issues that seem to be neurological based on how similar they are to what I deal with.

Big hugs to you @TooPatient. You are handling all these many challenges with grace and strength. You are an inspiration. Wishing you and your DH a full recovery.

 

[MamaBee]

Today is February 22. This is officially one year to the day since DH and I flew to a convention with my cousin and grandfather. I was a bit tired during the day, but mostly okay until we got home that evening. I was hit with the worst chills and deep body ache as soon as we walked in the house. I don't remember ever having such miserable deep chills before. The entire next week was just too fatigued and sick to remember. DH started to be tired a little less than a week later and then the chills and body aches hit him. I was miserable and barely functioning until somewhere around May. DH was out of work for just short of six months followed by a slow ramp up to full time over the next several months.

How are we now? I am okay. I have MS and many of the issues that are considered part of long COVID are part of my normal day. DH is still dealing with shortness of breath, fatigue, focus issues, random pains, and an assortment of other issues that seem to be neurological based on how similar they are to what I deal with.

@TooPatient I don’t have the words to say how sorry I am that you both went through this horrible ordeal. I hope your husband starts feeling better and improves to the point he was before he got sick.

 

[MamaBee]

Moderna moves forward on plan to increase Covid vaccine supply in each vial after latest FDA feedback

Moderna said it received "positive feedback" from the FDA on its proposal to increase the number of Covid-19 vaccine doses in each of its vials.

www.cnbc.com

 

[missy]

Moderna moves forward on plan to increase Covid vaccine supply in each vial after latest FDA feedback

Moderna said it received "positive feedback" from the FDA on its proposal to increase the number of Covid-19 vaccine doses in each of its vials.

www.cnbc.com

Hmmm. Hope they know what they’re doing. It’s all so new.

 

[MamaBee]

Hmmm. Hope they know what they’re doing. It’s all so new.

I think it just means there’s room for more vaccine in the bottles. I just hope when they are drawing the last bit left in the bottle there’s enough for a full shot. It would save the problem of manufacturing extra glass bottles which seems to be an issue they are dealing with.

 

[Ally T]

France has suspended use of the Astra Zeneca vaccine in several regions due to severe side effects.


ETA a source: https://www.leparisien.fr/societe/s...ter-12-02-2021-NAASFVX3WNCFHBKTZPRELS7D6M.php

To be more accurate:
The hospitals suspended the use for their staff, because the ratio of moderate size effects (high fever, flu symptoms) was so high that the hospitals were non functional from lack of staff.

3 of my doctor friends refused the AZ vaccine because of the technique used - apparently the viral vector approach does raise some concerns that haven't been publicly discussed at all ( in Europe).



Not great news..

So this was suspended there because of the side effects putting medical staff out of action for a few days, rather than a lack of efficiency at having the desired results against Covid?

If that's the case, then I can see how headlines such as this cause fear & scaremongering.

"We are ceasing to use this vaccine due to severe side effects" is very much a headline left unfinished. Makes me mad, because how many people don't actually go on to read the article & add the "due to side effects putting medical staff out of action for a few days, but have no fear because this vaccine does work well & will save your life..."

 

[Ally T]

The UK has now successfully vaccinated 16.5 million people.

My Dr friend says twice weekly lateral flow tests are detecting positive cases in her work, who are then going into self isolation, but these staff have been asymptomatic due to having been vaccinated. She is seeing the light at the end of the tunnel & finally beginning to relax that the worst is behind us for good.

Last night the Government set out a road map for the easing of lockdown, which has been very carefully thought through & each restriction lift is followed by a 5 week observation period. If that goes well, they will move onto the next restriction lift. All UK adults will have been vaccinated by July, with all restrictions & social distancing set to be completely removed by then, for the first time since last March.

We will have to live with this for several years & will continue to see cases, but the illness *should* be mild. We will be offered a yearly Covid vaccine along with our seasonal flu vaccine for the foreseeable. Fingers crossed.

 

[missy]

The UK has now successfully vaccinated 16.5 million people.

My Dr friend says twice weekly lateral flow tests are detecting positive cases in her work, who are then going into self isolation, but these staff have been asymptomatic due to having been vaccinated. She is seeing the light at the end of the tunnel & finally beginning to relax that the worst is behind us for good.

Last night the Government set out a road map for the easing of lockdown, which has been very carefully thought through & each restriction lift is followed by a 5 week observation period. If that goes well, they will move onto the next restriction lift. All UK adults will have been vaccinated by July, with all restrictions & social distancing set to be removed by then.

We will have to live with this for several years & will continue to see cases, but the illness *should* be mild. We will be offered a yearly Covid vaccine along with our seasonal flu vaccine for the foreseeable. Fingers crossed.

Wonderful news and fingers crossed!

 

[missy]

So this was suspended there because of the side effects putting medical staff out of action for a few days, rather than a lack of efficiency at having the desired results against Covid?

If that's the case, then I can see how headlines such as this cause fear & scaremongering.

"We are ceasing to use this vaccine due to severe side effects" is very much a headline left unfinished. Makes me mad, because how many people don't actually go on to read the article & add the "due to side effects putting medical staff out of action for a few days, but have no fear because this vaccine does work well & will save your life..."

Agreed. The hospital should have staggered the vaccinations for their staff so not everyone would be ill and out of work at once. Common sense.

 

[Ally T]

Wonderful news and fingers crossed!

Thanks Missy. We start with returning all children to school on March 8th, which cannot come soon enough. They have been home learning since Christmas & one of my girls is mentally going down hill.

All high school children will have a lateral flow test twice weekly. If that helps control things, we'll move to the next step.

 

[Austina]

There was an interesting article about that @Alex T. It was saying that it was the opposite of the placebo effect, basically those getting the shot were expecting to experience side effects, so did! I find it astonishing that certain parties would actually put out information that is actively discouraging people from getting vaccinated, out of what amounts to pettiness and inaccuracies.

 

[Ally T]

There was an interesting article about that @Alex T. It was saying that it was the opposite of the placebo effect, basically those getting the shot were expecting to experience side effects, so did! I find it astonishing that certain parties would actually put out information that is actively discouraging people from getting vaccinated, out of what amounts to pettiness and inaccuracies.

It blows my mind that they are even ALLOWED to put out such headlines or mis-information. And at the end of the day, I'll take my 48 hours of shitty side effects for immunity. Most of the people I know, including 77 year old mother & 75 year old MIL had the AZ vaccine, and besides a sore needle site & a couple of aching joints the next day, nothing. Those that I know who are still working & also had AZ, did not need to take time off work. Everybody is different & will react differently, some more extreme than others, as with EVERY vaccine out there, but headlines like that shouldn't be published in the first place. It's not helpful.