The news about the coronavirus and various treatments and vaccines was rather dour yesterday. Luckily, as individuals we can hear and understand that knowledge and use it to inform our actions to, as best as possible, protect ourselves and our loved ones.

Variants and Mutants

• It appears that the British variant is not only more transmissible, but also potentially more deadly.
• The Brazilian mutant has been found in a patient in Minnesota.
• There appears to be a “home grown” variant in California that may have contributed to the large explosion of cases and deaths.
• The South African mutant appears to be afforded neutralizing effects by the Moderna vaccine, but potentially not by the Pfizer one. Moderna is developing a booster just in case.

Vaccines

• AstraZeneca is going to announce to the EU version of the FDA that it is only 10% effective for people aged 65 and over, meaning it will not be approved in the US.
• Merck has ceased work on its two vaccines as they are not showing efficacy in Phase 1 and 2 trials.
• Johnson & Johnson may announce that they are seeking FDA Emergency Use Authorization in 2 – 3 weeks.
• Novavax is about a third of the way to their Phase 3 target enrollments, and their protocol called for a large number of people over age 65. They are starting to see requests from participants to be unblinded, and the rate is double amoungst those over age 65.
• West Virginia has the highest percentage of vaccinated population, mostly because they are NOT using chain pharmacies for distribution. When we look at roll out percentages, comparing State, hospital and pharmacy penetration, pharmacies outside of West Virginia do the worst.

What does it mean when something is “More Transmissible”?

I get this question a lot, and I am going to explain it in simple, non-medical terms. Think of someone smoking a cigarette, and of “transmissible” as how much smoke you can smell.

If you are outside on a windy day, you may smell a whiff of smoke from a single cigarette. The further away it is, the less you smell. You may not even see the smoke itself to smell it.

If you are in a well ventilated room where one person is smoking, you will see some smoke around them, and smell it no matter where you are in the room.

If you are in a small, poorly ventilated room and one person is smoking, you will see more smoke, it will hang longer in the air, and you’ll certainly smell it.

If you are in a small, poorly ventilated room and multiple people are smoking, there will be multiple clouds of smoke, and the smell will be pungent.

Think of the more transmissible variants as cigar smoke: they are stronger than cigarettes. The smoke from a single cigar is heavier and makes a bigger cloud than that from a single cigarette. It can be smelled from further away. Cigar smoke is more likely to “cling” to your clothes than an equal amount of cigarette smoke.

Hope that helps. While not scientifically perfect, when I start talking about viral loads and spike protein attachments, people’s eyes tend to glaze over.

Once I get the vaccine, I’m protected, right? I can go back to regular life, right?

Maybe to the first question, and a definite no to the second. The Moderna and Pfizer vaccines protect against DISEASE but we do not know if they protect against INFECTION. Understanding the difference is critical.

The vaccines have be shown to prevent disease in about 95% of the people who receive them. That means that a small percentage of recipients will get sick because their bodies did not produce the appropriate immune response. And while it looks good that the existing variants and mutants will also be protected against, there will be more changes in the virus, and the vaccines may not protect against them.

Let’s assume that you and a close friend are both vaccinated. You decide that you’ll get together like “in before times.” You hug and kiss, eat and drink. Both of you have virus particles in your nose, which you end up sharing. If the virus each of you has is the strain for which the vaccines were created, no problem. But if one of you has, say, the Brazilian variant, which has been shown to cause re-infections, it’s entirely possible that the other person could become infected and get sick. Remember, Covid causes mild illness in some people, death in others, and somewhere in between in the rest. None of us knows ahead of time into which group we fall. And people who are re-infected seem to have a worse time of it the second time around.

Finally, you need to continue to wear a mask and observe social distancing because only a small percentage of people have been vaccinated, and the vaccine does not protect you from carrying (and dispersing) virus particles from your nose. That means you might never get sick while still infecting many other people.

What should I be doing now?

Whether we get control of this scourge is a function of how quickly we can get 85% of the population vaccinated against the current strains. The sooner we accomplish this, the sooner the virus either burns out or becomes endemic. The longer it takes, the more opportunity the virus has to mutate. So, if you can get a vaccine, get one. If you know people who are offered the vaccine and turn it down, try and convince them to get it because we need to hit 85% ASAP.

If you can stay home, stay home. Yeah, I know, you have pandemic fatigue. We all do. People are depressed, anxious, eating and drinking too much. There is more violence and our kids are suffering. But more and more people are getting infected every day. They often don’t know where:

• “All I did was go to the grocery store, and that’s always been safe.”
• “In only had dinner with my daughter, her husband and their kids.”
• “It was ONE drink at the bar.”
• “I never left the house, although my kids went to school. But they’re not sick.”
• “I was in the office, and wore my mask all the time except when I had my coffee and donut.”

If you leave your house, if you interact with another human outside your bubble (or if they had a contact outside the bubble) you are at risk.

Not everyone can stay home. Essential workers cannot. And this is not just medical personnel and first responders, most of whom have already been offered vaccines, but also grocery store workers, delivery personnel, sanitation engineers, workers at power plants, sewer treatment facilities, etc. etc. etc. But if you CAN stay home, you make it safer for all of those people who must leave to keep the world spinning.

And yes, if you can get a vaccine, risk leaving your house and get vaccinated.