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

^^^Dr Fauci’s reaction is also telling. He moved up his estimate of “most Americans being able to get the vaccine” from “by the end of the summer” to April.

What we don’t know is the long term effects of the virus and the long term effects of the vaccine.

What’s also exciting is the concept of MRNA for other diseases. Perhaps Covid just accelerated this new technology that may help us with other diseases.

"he potential success of a Pfizer/BioNTech vaccine, will long outlive this pandemic, says Hotez. “It provides a glidepath for using mRNA technology for other vaccines, including cancer, autoimmune disorders, and other infectious diseases, as well as vehicles for genetic therapies. It really does help accelerate the whole biomedical field.”

https://www.google.com/amp/s/www.wired.com/story/why-its-a-big-deal-if-the-first-covid-vaccine-is-genetic/amp

@homerdog I thought I read that we would have to wear our masks for a little while after the bulk of people get vaccinated for the following reason: even though you are vaccinated, you can still spread. Say that the vaccine is in-effective in 10 % of the people, and another 5-10% can’t get the vaccine for whatever reason (I’m not including anti-vaxxers). If all the people would keep wearing masks for a little longer, the virus would substantially fizzle out as it won’t find effective hosts. I’d certainly be willing to keep wearing a mask for some reasonable period of time after the vaccination is fully distributed in order to protect these people. But I’m not willing to do this if there are a lot of anti-vaxxers who are going to blow herd immunity for everyone anyway.

I’m fine with that. Like I said, it’s just going to be interesting how the states change course over the time the vaccine is being distributed. How long will people have to show negative tests to get into New York? When will restaurants be open at 100%? When will high schools be able to go back in any normal way? How will the governors decide these things? I suppose they will look at the number of vaccines distributed but, like you said, at some point, if there are plenty of vaccines around and people aren’t getting them then even the governors will have to say that’s an individual’s decision and the rest of us are moving on.

I agree, it will be absolutely fascinating to see the timing and order used for loosening restrictions. We have so many different levers we use to prevent covid (as you mentioned, including: masks, SD, capacity constraints, remote work, remote school, prophylactic quarantining or test-taking for travel, maximum numbers of people allowed to gather, etc etc). I’m guessing most restrictions won’t change much until two things happen—most people have access to vaccine, AND the area begins to experience rapid decline in cases & deaths. But when that occurs, do all of the types of restrictions disappear at once, or is there an interim period where SOME restrictions stay in place and others go away—-

*. Do we mask, but can have 15 people, then 25, then 75, then 100, then unlimited people gather?
*. Do we get rid of masks but start out with still small gathering sizes?
*. Do we keep masks, but no longer social distance? Or decrease our distancing recommendations from 6 feet to 3 feet?
*. Do we say no more remote work or school, but keep masks?

It is SO FUN to think about this!! I wish so much it could be like the end of a war, like with the fabulous famous nurse/solider kiss photo where the nightmare just ends instantly. So great if everyone could run into the street and start hugging their neighbors at once! But of course it will be more gradual. So excited to see how it plays out…

You can certainly feel free to celebrate early if you wish. I’ve been in the science field for decades and seen way too many promising things turn out to be not as promising as they first seemed. I prefer to celebrate when the final bell has sounded, not after the first quarter or half when it looks like the team is leading.

I definitely prefer a lead to being behind, but that’s as far as it goes.

Being the parent of a long hauler with Covid, I don’t plan on letting my guard down until I’m convinced with a bit of data. We do, however, like anyone else, take risks we determine to be worth it - like our recent visit to my med school boy to have an early Thanksgiving with him. Now we’re isolating to protect FIL (and anyone else) because there’s no way I’d go from one to the other the way things are.

I’m not anti-vax at all - have my flu shot, Shingrix, and plenty of others to travel in the past. I’m anti Covid. I also know the limits of science and prefer realism to optimism or pessimism. When full data is out there, even post “test” data (once a project gets to go, more data is collected), then I make final conclusions.

From what I’m seeing, a lot of people won’t get the vaccine. My running partner, an intelligent woman, said she is going to wait a year to get it to make sure there aren’t any severe side effects. I told her I will take my chances and be first in line.

I think non-compliance is going to be a big issue and mean masks are required for a long time. ?

I don’t plan on being first in line, but that’s because we’re not really super high risk. We’ll be in line when it seems we should be (as with Shingrix), but I plan to continue watching data come in even after getting the shot. I doubt there are severe risks to getting it. The question is how much help will it do and can we trust that aspect of it. There’s a lot of money at play, and as much as we wish it wouldn’t, that can affect what some people do - even with numbers. I’ve seen it happen for less (second hand, knowing IRL the first hand people in the fray with other issues).

I’m anti-Covid. It would kill FIL and if there’s a genetic component, my son getting a long haul case could mean I’m more likely for it too. I don’t want to assume all is normal if it isn’t. Sooner or later we’ll have a lot more data, both before an official go and afterward.

Geez. We are not negative Nancies. You’re looking at one sliver. We’re just saying, wait to see more.

You don’t have to get the virus to properly test.

It will be interesting to see how this plays out. I am not anti-vax in anyway. But I will not be first in line for the vaccination. I have been a pharmacist for over 30 years and I have seen new drugs come out over and over and over again that were “so great” and then they ended up having an unexpected side effect after hitting the market. I will see how the first group does and then decide. I know a lot of other health professionals who feel the same.

^^ This.

We have had multiple family members throughout the country with no underlying conditions in the 40-60 age range being told by their doctors to wait 6-12 months before getting a vaccine. It may be a long haul.

While I’m not in the “at risk” group, I am certainly never going to be one who jumps first in line…for nearly anything! I am a watch and see kind of person. I’m not anti-vax, but I also don’t get a “flu shot” every year, I prefer to let my system fight hard, and it’s usually around 3 years or so between them. I am not getting a flu shot this season as I’m working from home, with little to no exposure. I want my immune system to stay naturally healthy. I hope I’m not naïve.

Wouldn’t getting a flu or other vaccine give your immune system more “practice” or “exercise” than not getting it?

Exactly.

Not the same as a vaccine, but my mom used Zantac and now is dead from esophageal cancer. No one is able to figure out where the cancer came from. There is no known cancer in her family line, she never smoked, hardly ever drank, and isn’t male. Having checked briefly into the lawsuits advertised, she’s not really a candidate for much since she was 76. Her parents lived to be 88 and 94, so I feel cheated out of a decade and a half.

It might color how I feel about new and great things - even though no one can definitively say Zantac was the cause. “It’s safe, they said.” Was it? A lot of money was there to be made.

Meanwhile, my mom isn’t coming back.

Covid can be nasty even if one doesn’t die. Is a vaccine going to return life to normal? Maybe. Or maybe folks want a lot of money and know odds are good that most won’t die anyway - anyone who does can be explained by the odds or whatever.

I’m willing to wait and see what happens after a lot of people get vaccinated and I’m fully fine with anyone who chooses to be first in line. We need guinea pigs. I just won’t be among them. I’ll be watching the data.

Since we probably will be in line somewhere I’ll be watching the data after that too before assuming all is well. I’m more worried about numbers not holding up with this one than I am of adverse issues.

I often don’t get flu shots - I’ve had the flu twice in my life, but I think you are nuts not to get it this year. I got mine a couple of weeks ago.

When I heard this week from an online acquaintance that her healthy 37-year-old husband died from COVID, I decided I would take my chances (which I consider to be very low) and get the vaccine as soon as I’m allowed. My husband is older so he will be allowed to take it before me, and he plans to get it as soon as he can. I’m also relying on the advice of a physician friend at Vanderbilt who was part of a vaccine trial and said he will get the vaccine as soon as it comes out.

So some of you are going to be up for living like this for the foreseeable future? Paying thousands for college kids to have crummy college experiences? Low income K-12 kids falling behind? Millions losing jobs? That’s your choice I guess. I’m betting that, when faced with taking the vaccine and getting normal back versus waiting longer (how long?) to feel more comfortable, a lot more people will take the vaccine than some of you think.

I’ll just hope that vaccines will be mandatory for all of the things I wish would come back and you all who won’t take it can keep living the way we are living.

What is your point, @homerdog? What part of this analysis do you take issue with?

Actually, I expect to get my best data because I presume most people will get the vaccine and return to life as normal just as many have without the vaccine due to Covid fatigue. Within 4-6 months post vaccine we should have a really good grasp on how it did - good, mediocre, or bad - or anywhere between those markers.

We are fortunate that we no longer have kids in school or college (last year of med school for one) and we enjoy life here on our farm, so it’s not the downer some have with their lives. We enjoy it. We play games, we watch TV/movies, we read, we connect online and via phone more than we did before TBH. We’ve learned we enjoy take out as much as eating in. With most places we know where to get a better view.

Travel is something we miss, but not being able to go new places hasn’t drastically affected our lives the way long haul Covid would. Masks when we head out are an inconvenience, but they are hardly anything I lose sleep over having to do.

I don’t want life to stay this way forever, but I don’t think it will either. I’m willing to wait until more is known rather than risk the rest of life as a long hauler - esp when what’s left of the waiting time could be relatively short even if it’s another year (comparing to the rest of expected lifespan). If I were unhappy now that would probably color things differently. I’m not.

You seem very concerned that this vaccine might not prevent asymptomatic cases. I have not heard or read any concerns about that anywhere else. I haven’t seen anyone say “well it only prevents symptoms and not asymptomatic cases and that’s a grave concern”.

The goal is to stop the sickness and the deaths, no? What am I missing?

I get that someone who is vaccinated might still be able to contract a asymptomatic case (jury out on that but that’s what you are saying). Why does that matter?