COVID vaccine update

[TUPF]

We appreciate the updates, AO. Don't worry about being too long, it's good info.

True dat.

[NJwave]

My father who is in a nursing home had his first shot a week ago. It was a huge relief for my entire family. My wife had her first round earlier in the week. I received my daily automatic robocall from our County Executive saying they are vaccinating police and firemen now. I know the national reports claim the rollout has been terrible, but we seem to be doing pretty well in my area.

[AO Sig]

A quick update I just read. Early on there was concern about two BP medications, the ACE inhibitors (lisinopril, enalapril, essentially any one with "pril" at the end) and ARB (Angiotensin receptor blockers- losartan and irbasartan are the biggies) were worrisome because there was concern that they could help with the growth of the virus.

A new study that came out today in the Lancet looked at people who were in the hospital on these medications, seeing whether holding them would improve outcomes. They saw that there was no difference in the outcome- going on a ventilator, death, etc.- if the medications were stopped or continued.

The take home of this is that these commonly used blood pressure medications do not seem to have a clinical effect on COVID infection. this is sort of important because older patients, who are more likely to have high blood pressure, are the ones also susceptible to a worse outcome in COVID. for those of us with HBP and on these medications we don't have to worry as much that the BP medications we take put us at a worse risk than just having HBP does.

[AO Sig]

Read several quick hits on the COVID front. First- researchers estimate that 50% of cases are being transmitted by asymptomatic people. I can speak from experience on this, as my partner had mild nasal symptoms, discovered she had it; her husband had no symptoms, but has high antibody titers. they do not know where she got it from at all. Scared her because both of her parents are in their 70's, and had it, as did her daughter (who stays with grandparents while she is working). No original vector has been found.

Second study is on the two mutations; one is "UK," the other "South Africa." They are both felt to be more contagious; however, in past epidemics these mutations might be less virulent (causing bad disease). Additionally, the Pfizer people say their vaccine protects at least against the UK one, which has been seen in the U.S. Have not seen information on the South Africa coverage; will watch for it.

Because of their being contagious, and because of the number of cases spread by asymptomatic people, I think that stopping it is going to take a multipronged approach. Vaccination will be important; I just heard that Astra-Zeneca might release more data this week, which suggests an FDA application soon if the data is good. Moderna claims to be able to have 1 billion (yes, that is with a B) doses this year. Also waiting on Johnson and Johnson.

Second, the masks; I realize that people are still hung up on their rights not to wear them, and the early pronouncements from Fauci and the WHO that they are not needed, only to change their tune; the truth is that they do a better job of keeping YOU from spreading it to others, rather than others spreading it to you. The point is that you have a right not to wear one; but if you are one of those asymptomatic carriers and spread it to family (my mother is 88, got her first vaccine dose last week; might let me have dinner with her on her birthday), neighbors and friend, how will you feel if they aren't asymptomatic?

Third is the physical distancing. I personally feel the term "social distancing" is an oxymoron. Humans are social creatures- just look at the multipage threads we have here. If we can make the numbers drop, we might be able to be sociable again before the end of the year. I make no guarantees, just hopes. The thing is we are talking about contagious viruses; masks and separation reduces it being spread.

More later...

[tulaneoutlaw]

Thank you, AO, for the continued updates. Really helps to have a strong medical voice to cut through some of the noise out there.

On my personal front, I will say that I'm now very confident in the vaccine's efficacy based on my own personal experience. Despite limiting Christmas interactions to less than ten total people, an out of town sibling brought covid to our doorstep. Six out of eight total family members, including my wife, developed symptoms of varying degrees and subsequently tested positive. My wife has spent the last week slowly recovering, spending a good deal of the time in bed. It seems that everyone is on the road to recovery, thankfully. Meanwhile, because I've been vaccinated, I had absolutely no symptoms.

When a vaccine becomes available to you, get it. You'll be happy you did.

[TUPF]

outlaw, unfortunately your family's experience seems to play over and over and emphasizes that all it takes is one slip up to spread it.

AO Sig, I would be very interested in any info related to the vaccinated people, or the people with antibodies after going through COVID, being still able to asymptomatically spread it. Typhoid Marys, COVID-19 style.

[AO Sig]

No information on this yet. I can tell you that we are being told that even though we have been vaccinated we need to continue the masks because of that concern. I get my second dose Friday; will report how it goes to y'all this weekend.

[PeteRasche]

The thing that killed me over the holidays were the innumerable instances where I saw "oh, we were careful and kept it small this Christmas... Spent Christmas eve with my family, just my mom and dad, grandma, my sister and her husband and their three kids. On Christmas day it was only my spouse's mom and dad, his grandma and grandpa, his brother and two sisters. We just couldn't keep our kids from seeing their grandparents!"

Because, you know, if you see them one day apart it magically prevents transmission.

The number of people who thought "as long as there's only a few people in the house, we're safe" was just astounding. What the experts were really saying by "gatherings of less than 10" was intended to mean that:
A. With only 10 people you could stay distanced within the house. And you're all wearing masks, too. And no hugging!
B. If you only see that few people, at least the spread will be limited if someone infected everyone there. And you all stayed quarantined from everyone else in the following week or so, right?

It's just so hypocritical. Families gathered, no masks were worn, and grandma hugged all her family members, just like always. And the next day, all those families intermingled with the other spouse's family. The only thing it did was give people an excuse to uninvite weird Uncle Chuck.

And people don't seem to care that hospitals are overwhelmed and the past couple of days have been the worst in many areas since this started last winter. That fact isn't even the top story on the news.

Local news this morning talked about a kid from a local high school, basketball player on their varsity team, perfect health, almost died from cardiac issues after getting that inflammation thing that COVID can cause in kids (the one that got a little news coverage back last April or May). He seems to be pulling through, but the attitude that anyone under age 40 is invulnerable almost took a blow there.

[Carolina Greenie]

Gosh, I hate Uncle Chuck

It’s really thick here in Metro Charlotte

We have 4 docs (10 percent of our practice) rotating every week to assist the beat down docs in our hospitals get through the next couple months.

I’m signed up to give vaccines in a circus tent vaccine center for the next few weekends. (That’s a first for me in 25 years of practice)

Got my second dose yesterday. It’s a bitch. But it will pass.

Fun times

Wear your damn masks.

[TUPF]

Pete, you are beating you breast to the already converted, or the never will be.

My next door neighbor, a mid 40s woman whose husband is a Baltimore police officer (he comes home in days off since its 2 hours away) contracted COVID-19 during the holidays. Don't know many details since she has never been warm and fuzzy to anyone in the neighborhood.

So last night I'm standing on my back deck and I see her outside raking leaves and to be neighborly I say "hey, good to see you up and around...heard you had a case of the nasties recently." He response? "Yeah, but it wasn't bad. I don't know why people are making such a big effing deal about it." I was stunned and just turned on my heels and went inside, not because she didn't end up in the ER like others I know but because of the callousness of the mindset that says I got it but it wasn't terrible so everyone else must be wrong.

We are rounding the corner to 400,000 American deaths and it wouldn't surprise to see half a million laid squarely at the feet of personal behavior.

[tulaneoutlaw]

Pete, I agree with you. The buck stops with me for even bringing my family. That said, we were led to believe holidays were going to be done a certain way when behind the scenes they were not. Only after this got passed around was it revealed that there were some people who openly broke the family "rules of operation" leading up to and during the holidays. It's led to some very ill feelings because the behavior of a couple impacted everyone. Knowing that this kind of breakdown was even possible, I should've politely declined. I certainly wish I had.

[ml wave]

Pete, you are beating you breast to the already converted, or the never will be.

Unfortunately, that's basically everyone.

[PeteRasche]

Pete, I agree with you. The buck stops with me for even bringing my family. That said, we were led to believe holidays were going to be done a certain way when behind the scenes they were not. Only after this got passed around was it revealed that there were some people who openly broke the family "rules of operation" leading up to and during the holidays. It's led to some very ill feelings because the behavior of a couple impacted everyone. Knowing that this kind of breakdown was even possible, I should've politely declined. I certainly wish I had.

I'm "lucky" (I guess) that my family is very small and almost entirely elderly except my family and one other second cousin who lives out of town. Lots of branches with an "only child" or no kids at all so no real questions about whether any get-togethers were canceled (they were) or whether anyone had "cheated". We all agreed we'll do "Christmas in July" outdoors this coming summer.

What you described is why I did not let my kids play basketball this year; no matter how well our school does to keep kids safe, they still have to play other schools and you have no idea what those people are doing. It only takes one person.

[TUPF]

What you described is why I did not let my kids play basketball this year; no matter how well our school does to keep kids safe, they still have to play other schools and you have no idea what those people are doing. It only takes one person.

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

[PeteRasche]

What you described is why I did not let my kids play basketball this year; no matter how well our school does to keep kids safe, they still have to play other schools and you have no idea what those people are doing. It only takes one person.

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

The league my daughter would have been in (5th grade) started play in November and shut it down by early December because so many games were being canceled. They just resumed this past weekend and I'll be curious to see if they make it through the rest of the season.

[GretnaGrn]

What you described is why I did not let my kids play basketball this year; no matter how well our school does to keep kids safe, they still have to play other schools and you have no idea what those people are doing. It only takes one person.

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

The league my daughter would have been in (5th grade) started play in November and shut it down by early December because so many games were being canceled. They just resumed this past weekend and I'll be curious to see if they make it through the rest of the season.

Rec league football was strictly intramural and flag only where we live for just this reason. They tried to start basketball (also intramural only) but it was shut down before any games were played. We did sign up for football; we would not have done basketball even intramural.

[WaveProf]

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

I thought your daughter lives in London?

[Sophandros]

Probably posted before, but if you haven't done so then I recommend subscribing to Tulane Outbreak Daily, which is run by our School of Public Health & Tropical Medicine.

https://mailchi.mp/tulane/subscribe

[TUPF]

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

I thought your daughter lives in London?

One does.

[Roller]

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

I thought your daughter lives in London?

One does.

The one you are so proud of that we've never heard of her sister?

[TUPF]

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

I thought your daughter lives in London?

One does.

The one you are so proud of that we've never heard of her sister?

It's complicated but has ended well.

[gerryb323]

That is EXACTLY what happened with my daughter's family in Dallas. Basketball playing middle schooler in private school brought it home.

I thought your daughter lives in London?

One does.

The one you are so proud of that we've never heard of her sister?

[gerryb323]

I, for one, am of the opinion that Down Periscope, starring Kelsey Grammer, is a much better submarine movie than most give it credit for.

Quick, Hunt for Red October or Crimson Tide?

[Yankeewave]

Run silent run deep

[Yankeewave]

Actually, Red Storm Rising is the best thing ive read about submarines. Its mot exclusively about subs but people i know who Served on subs thought it was a very good good book.