Glossary

• Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
• Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
• SARS-CoV-2– the specific name of the new coronavirus
• COVID-19-the name of the illness that the new coronavirus is causing
• Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
• Epidemic– a sudden burst of an illness that comes and goes over a limited time
• Pandemic– an epidemic that bursts across the world not just one region
• Spreadability– how contagious is the disease, how many people will end up infected
• Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
  • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
  • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
• Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
• Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
• Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
• Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
• Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
• Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
• Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.
• Vaccine Terms
  • Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
  • Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
  • mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
  • mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
  • Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

YES, Immunize our Children- ASAP

Across America, the doors are opening to immunizing all people ages 16 and up.  Here in Ohio that door opened Monday, March 29.

Many families are asking me, should I immunize our 16 year old, 17 year old, 18 year old?

The answer to this is simple:  YES!

Some wonder, is the COVID vaccine safe for 16-18 year olds?  YES.  The COVID vaccine has been given to half a billion (!!!) people, with no serious side effects beyond severe allergic reaction which happens only very rarely.  There is NO difference in safety for 16-18 year olds and older adults.   It is stunningly safe.

Some wonder, could the COVID vaccine cause unanticipated problems with the immune system later in life?  The answer is that so far we would say NO.  One thing we know for sure- getting infected with COVID-19 is FAR MORE DANGEROUS that getting the COVID vaccine.   We are seeing millions of people with COVID-19 infection suffer long-term neurologic, gut, joint, and other harms.  NONE of these troubles have appeared in the nearly half a billion people injected with COVID vaccine.

Some ask, when will kids 12-16 years old be able to get COVID-19?   The answer is we do not know.  The vaccine manufacturers are close to completing study of the vaccine in this age group, and when done, will apply to the FDA and then the CDC for approvals.  The world will know when they apply to the FDA and CDC and if and when they get approval.  The day after they get CDC approval, which always is granted only after the FDA approval, then 12-16 year olds can be vaccinated against COVID.  So watch for that news, I expect to happen soon, within weeks or a month or so.

Some ask, will Advanced Pediatrics give COVID-19 vaccine?  We are a registered COVID-19 vaccination center, and are talking with the Ohio Department of Health now to ascertain if and when we would be asked to give these vaccines.  The decision is entirely in the hands of the ODH.  Stay tuned.

The Power of the Middle- the US Roars

Spring is in the air, the burden of COVID is lifting.  Schools are opening.  Deaths from this catastrophe are less.  Immunizations are soaring upward.

But as readers of Real Answers know, this does NOT mean the Pandemic has Ended!

We remain firmly in the grip of the Middle.  But because so much of America has decided we have left the Middle, are in the End, travel and gathering have exploded across the nation.   This is a tragic mistake, because if you jump out of the trenches before the war actually ends, you can easily still be wounded.

That is the Power of the Middle, ignoring the fact that the Pandemic still can rage, and acting as though the danger is past.  And we are sadly seeing this Power in real life.

Fueled currently by very, very dramatic rises in COVID in Michigan, New Jersey, New York, and other states, our nation’s case numbers are rising.   The concern is that an actual surge with all the deaths that come with surges may be erupting, perhaps driven by the more contagious variants.

So please, we are urging everyone, to remain careful.  Not gathering now, not travelling now, wearing a mask and keeping distance all can help the variants from gaining a foothold, help the immunizations move us to the End of the Pandemic.  If do not, the rising cases tell us we will remain under the Power of the Middle.

Lessons from Tracing an Outbreak Nearby

Another state seeing a real rise on COVID is Minnesota, a Great Lakes neighbor of ours.

This is also the home state of Dr. Michael Osterholm, who praised the results of an intensive tracing of the actual source of infection in a series of outbreaks of COVID near Minneapolis, in the suburban Carver County.

The outbreak infected 140 people in this county, involving 50 schools and sports teams.  A full 25% of the infections were the UK variant, also known as B1.1.7.

A quote from the report shows how this variant does indeed cause outbreaks tied to kids younger than high school:

“An outbreak of at least 12 infections at one K-8 school was tied by one person to a sports team with five infections, which were linked to a local high school with more than 20 infections among students and teams. One student from that school had ties via a recreation center to two other people who tested positive.”

“The cluster ensnared four private schools, nine public schools, one child care center, 18 hockey teams, four basketball teams, three lacrosse teams, one soccer team and three fitness or recreation centers. Transmission occurred across county lines, with a B.1.1.7-driven outbreak among most girls in one Shakopee hockey team having a link back to the Carver cluster.”

https://www.startribune.com/mapping-of-carver-county-outbreak-unmasks-how-covid-spreads/600036697/

Note that the outbreak began at a K-8 elementary school, spread to sports teams that eventually led to 18 hockey teams having COVID, as well as basketball, lacrosse, soccer, and rec centers involved.

This outbreak and its trace establish that the B1.1.7, or UK variant, can cause outbreaks to erupt from schools with younger children, and that children’s sports teams are some of the best transmitters of COVID.

Lessons from Afar

Israel continues to lead the world in immunizations.  It remains, as of today, at 55% of its people fully immunized.

With a national level of immunization, Israel is reporting the following observations, all good news for everyone around the world, including all of us:

1. The COVID vaccine works.   In the field, looking at 1 million fully immunized, it is observed that the chance of getting really sick, or dying, from COVID drops 95%
2. The COVID vaccine seems to stop transmission.  We are not sure of this yet.  But preliminary data suggest that if you are fully immunized against COVID, the chance you could get an infection without getting ill and that you could spread the virus to someone else in this condition, is reduced.  These data suggest the risk of spreading COVID when feeling fine also drops 95%.  https://abcnews.go.com/Health/pfizer-vaccine-shows-94-effectiveness-asymptomatic-transmission-covid/story?id=76389615
3. If you choose not to get a COVID vaccine, your risk of dying from COVID (if you are an adult), is 29 times higher than the risk of someone fully vaccinated dying of COVID.

These observations are all in the setting of a nation where the vast majority of the COVID is the UK variant, B.1.1.7

Bottom Lines

1. It’s a beautiful day, the sun is shining, the air is warm.  But the Pandemic is NOT over.  We remain squarely in the middle of it, and with the arrival of the UK Variant, this is a particularly horrible time to give up stopping the spread.
2. The outbreak in MN so closely followed proves that major outbreaks are now possible with the UK variant from schools with kids younger than high school.  We are so close to ending the Pandemic, how awful to see that our zeal to celebrate Spring together might invite the UK variant into our schools and make schools a questionable place once again.
3. The COVID Vaccine works and is safe!
   • Everyone eligible for this vaccine should get it ASAP because it drops the chance of dying from COVID 95%
   • The COVID Vaccine is as safe for a 16 year old, as 17 year old, as 18 year old, and adults.
   • Those who choose not to vaccinate for COVID may face a risk of dying from COVID 29 times higher than those who are vaccinated.
   • The COVID Vaccine even reduces the chance of spreading the virus, even if you have no symptoms, perhaps dramatically.
   • The COVID Vaccine trials in 12-18 year olds are nearing completion, you will know when the Vaccine is approved for 12 and up when the CDC approves it happening which will be very big news.  We hope to be able to make it available here, but await word from the Ohio Department of Health.
4. A handful of exceptions are opening up to allow some to gather, but only relating to those fully immunized, and limited to small groups.  We hope to see other chances to get together emerge, but they only will if we all remain careful, acting on the knowledge the Pandemic is not over, yet.

My Takeaway – In One Sentence:

Variants are surging, please, please, please, get immunized, and until the Pandemic Ends, do not travel, do not gather, stay masked, stay distanced. (And we must keep in mind some sports do spread this virus!)

To your health,
Dr. Arthur Lavin