Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Since we don’t know… if we want to protect others, the only way to do so is to still wear them until the results are known.

Those who choose not to wear them now are unlikely to do so post vaccine. They already don’t care about protecting others. We (Creeklanders) are not in that group.

There is not going to be a vaccine within 6 months or a year that will have enough of a history for us to KNOW how effective the vaccine is long-term for reducing incidence of serious illness or reducing the possibility of contagion and spread in an asymptomatic/mildly symptomatic setting. There just isn’t enough time to have the answers to those questions — you can’t follow a vaccine trial participant for 2 or 3 months and know whether or not the vaccine remains effective 6 months down the line. Maybe it will be, maybe it won’t – but the answers are only going to be apparent when there is long-term data.

I think it is valuable and important to develop a vaccine early on, but people need to be aware that this is an emerging science, highly likely to be supplanted down the line. That is, the vaccine you will be able to get in early 2021 is probably not going to be the vaccine that people will be getting in 2022.

I also don’t think we are going to get to herd immunity anytime soon based on vaccinations – just too many unaswered questions, too many people who won’t be vaccinated for whatever reasons. Also, the vaccines are not being tested in children – so children won’t get them, but may remain a vector for the disease in the future. But the value is that people who work in fields that put them at higher risk for either contracting and spreading the disease can be vaccinated early on – and that is going to reduce and contain the overall spread of the disease.

Also, once there is a vaccine there will be the ability for a rapid response to launch vaccination campaigns in areas where there are outbreaks. That is, instead of shutting down businesses, the local health departments may be able to launch vaccination drives and also impose vaccination requirements on some types of high-risk businesses. (I think it would be overreach to mandate vaccination for everyone, but certainly vaccines could be mandated for all staff at nursing homes, as an example.) So again, that’s going to contain the overall spread.

Assuming a vaccine is developed (with adequate support for me to be confident of safety), I don’t plan to rush out to be in the first wave of vaccinated people. Based on my age I am high-risk, but I think as far as the community is concerned, I am low priority. (I live alone, and rarely engage in the sort of activities that are super-spreader events). If there was an unlimited supply of vaccine… sure, but there won’t be. So I will wait my turn – which means people whose work or living situations put them at higher risk of exposure should go first. I’ll hold off until there is widespread availability and supplies are stable.

@CardinalFang my post regarding masks and immunity was a direct quote from STAT. Just a copy and paste.Sorry I didn’t indicate that. Of course I agree that proof is needed to indicate something is “proven.” The article linked indicates that that theory is still in preliminary stages.

Still it is an interesting idea.

Hmmm, we can’t have much of a rapid response with many of these vaccines. Both the Pfizer and the Moderna vaccines require one shot, then another three or four weeks later, then (they think) it takes a couple of weeks for the immune response to kick in.

Looks like another vaccine candidate is going to phase 3 trial (press release):

https://www.jnj.com/johnson-johnson-initiates-pivotal-global-phase-3-clinical-trial-of-janssens-covid-19-vaccine-candidate

Three potentially huge advantages to this vaccine:

-Known technology may lead people to be more comfortable with safety (a couple of the other Phase III vaccines are novel technologies)
-One injection, rather than two which are 4 weeks apart
-No need for cold chain storage

I thought some of you might find this newsletter of interest. It’s from the University of Washington. A team sifts through material daily to highlight what appears to be most important in the avalanche of studies, reports, etc.

“COVID-19 Literature Situation Report is a daily (M-F) newsletter that provides a succinct summary of the latest scientific literature related to the COVID-19 pandemic.”

https://depts.washington.edu/pandemicalliance/category/covid-19-literature-situation-report/

Sobering news in my inbox from the NYT:

“Global virus deaths have passed 1 million, more than the flu, malaria, cholera and measles combined have killed in the months since Covid-19 emerged.”

May medical advances continue.

Very interesting article that makes a case for “backwards” contact tracing to find super-spreader events.
https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/

Other things the article mentions:

  • Superspreading events versus many infected people who infect no one else.
  • Risks associated with indoor continuous exposure, particularly with talking, singing, etc..
  • Usefulness of cheap fast tests, even if they are not as accurate as expensive slow PCR tests.
  • Things that Sweden did that do not fit the usual narratives (either praising or criticizing) its response.
  • What South Korea and Japan did that targeted superspreading situations, versus some other countries that had burdensome restrictions that did not stop superspreading situations (e.g. the UK limiting outdoor gatherings to six people but allowing pubs and bars to remain open).

Speaking of contact tracing… last Friday, a secretary (Same employer/different building from me) was having Covid symptoms and went to be tested. Tuesday the results came back positive. Secretary’s boss was told by HR to keep working unless he had symptoms and to wait to see if called by the contact tracer. He could get tested “only if he wanted to.”

He went today to get tested. While waiting, the contact tracer called. They said he had to quarantine for 14 days, but testing was not needed. He lives with his D and his wife (my coworker). She takes care of her medically fragile elderly mother.

Does this not sound odd? Wouldn’t you want someone to know if they had gotten infected because a full week had passed from secretary’s symptoms to him being told to quarantine? He did go through with the test, I believe.

@ClassicMom98 that’s a terrible call by the employer. Keep working until you have symptoms? No testing but quarantine for 14 days, and he was exposed 10 days ago! Ugh!

Not odd, almost criminal. Ugh!

My husband’s company on the other hand is so very careful. Their COVID rates are very low. My husband currently has an employee on a 14 day quarantine as he encountered a person with a positive COVID test His company gave everyone 5 more personal/vacation days to deal with any personal situations. A couple of weeks ago, one of H’s supervisors had a reaction to a flu shot. He had to call the company health line and could not get back into his work site until he had confirmation from the doctor that it was a flu shot!

Re: #2190

Imagine if he had a book of those cheap lick-the-strip tests. If he did, he could test every day (or even multiple times per day); if positive, he could self-isolate to protect the workplace and his relatives.

Instead, he may have needlessly risked exposing others over the past few days or may be going through a needless quarantine.

That’s just nuts. I don’t understand what that company was thinking.

@yucca10 that was a really interesting article. I thought the analysis of different country’s approaches was very interesting. There were definitely thoughts I had not seen before.

@mathmom it’s actually my company. Both my co-worker and her H work at the same place. Just different departments and buildings.

The HR policy was not surprising. We have all been “trained” on it, signing legal documents that we have read it all. That’s what is in the policy. I don’t agree with it, but it’s there. The contact tracing part did surprise me some. But most of the people I know who had it in my state were not contacted at all, so I suppose it’s a step in the right direction.

I do live in an area where most people think it’s overblown and/or a hoax. And the mental institute made the papers when someone leaked that they were instructed via email to keep working if they tested positive but were asymptomatic. The publicity made them change their policy, but one nurse has since died. I sense a lawsuit will be coming there

I’m pretty sure that would never fly in New York.

Some people seem to have missed the notification that Covid appears to be most transmissible prior to symptoms showing up. Some of that is likely due to folks not changing what they are doing because they don’t know, but not all. It’s a trait Covid has whether someone changes plans or not.

To not change plans when you do know you could have it seems lawsuit worthy if you give it to someone who takes a bad turn.

From New Zealand, it was determined that the virus spread in their Quarantine location via a trash can. So there is still some form of surface transmission. New Zealand is up there in contact tracing. They find everyone and it also seems like everyone behaves properly. They want to know the root of every case.

It seems the they stopped community transmission again.

Yup. Science is running as fast as it can, but we’re in uncharted waters. (That expression isn’t even sufficient.)

The undertone to many friend conversations has been, “When do people freaking grow up?” And of course I feel deeply for those who do try, but have others around them who are flaunting cautions and delivering covid to their doorsteps.

I just signed up for COVID Alert NY app. It will alert me if I have been in close contact with someone who has tested positive for Covid. I know I am giving up my privacy, but I think it will be worth it. I hope more people will sign up for it.