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.

COVID Vaccinations Safe for Adolescents

This week we all had a scare when the CDC did its job and shared a question about if the COVID vaccine has anything do with inflammation of the heart.

Yesterday, the CDC concluded their study of this question, very thankfully the answer is a firm no.

What happened?  Let’s take a look at the worry, and how the worry is figured out.

The Worry

The worry was the report that a small number of adolescents who experienced myocarditis, or inflammation of the heart and they also had COVID vaccination.  Did the myocarditis happen because of the vaccine, or would it have happened without it?

The Process

The issue is that when something happens to millions of people, normal events will still happen to them, having nothing to do with the something that happens.  Think about haircuts and colds.  Clearly they do not cause each other, right?  So consider the fact that last week many millions of people got a haircut.  And now consider that many of them experienced their first symptom of a cold the same day they got a haircut.  Did the haircut cause the cold?  Or would the cold have happened anyway, it just happened to be the day of a haircut that it began?

At the same time sometimes unusual events are caused by something experienced by millions.  Think about the millions of people who take Adderall for ADHD.  Some of them have trouble sleeping.  But many people have trouble sleeping. So is the trouble sleeping that some people have something that would have happened with or without the Adderall, like having a cold the day of your haircut?  Or does Adderall actually cause trouble sleeping?  It turns out people who take Adderall are far more likely to struggle sleeping than those who do not, Adderall clearly causes insomnia.

The question the CDC, that we all face, is whether the adolescents with myocarditis developed this problem from the vaccine or not?  Is the myocarditis like the cold after a haircut, or trouble sleeping after Adderall?  Would these adolescents have developed myocarditis even if they never got the vaccine (so like a cold after a haircut), or would they have been far less likely to have had myocarditis if they never got the vaccine (so like insomnia on Adderall)?

The Result

This is just the sort of question the CDC is one of the best places in the world to figure out.  They look at the numbers, and the key number is how many adolescents get myocarditis in a typical period, a time before COVID?  Say about 10 get it a month, then they can tell if starting use of COVID vaccine increases that number.  If it does it may cause it, if it does not, it does not.

So the CDC did just the right thing.  They shared with us the observation that some adolescents had developed myocarditis, they let us know they were looking at it, and then they study the facts.

Very thankfully, the CDC has found that there is no link between our children getting COVID vaccine and a serious problem like myocarditis.  There just has been no increase in myocarditis since COVID vaccination began in adolescents.  That is very, very good news.

We can now say with tremendous, solid, and very reliable confidence that the COVID vaccine is safe for children ages 12 and up.

The End of the Pandemic Approaches in the US

We have written at some length about the trajectory of the devastating COVID Pandemic.

Remember last year and the start of this year, when we reported the catastrophic loss of massive numbers of us?  We would post special notices as we reached 100,000, then 200,000, then 300,000, then 400,000, then 500,000 lives.  Each time was devastating, and it seemed there would be no end in sight.

And then came not just the vaccine, but a program that worked to make the vaccine easily available.  Tightly tied to this overwhelming work is the sharp drop in deaths in the US.

They have not stopped.  We marked the loss of 500,000 lives around February 9 of 2021.  Today we mourn the loss totals reaching 588,287 lives.  But the daily loss of life has dropped to around 500 deaths a day.  This is still bad, very bad.  But to lose another 100,000 deaths, at 500 a day would take 200 days or about 6.5 months.  Just back in January, it only took 1 month for 100,000 Americans to die.

Here is the point, COVID vaccine and only COVID vaccine is putting the brakes on this Pandemic.  The United States suffered about 60,000 cases of COVID a day one month ago, now it is down to 25,000, that’s a huge drop.

The COVID vaccine works so well that all of us fully immunized no longer need to worry about catching COVID, or spreading it.  As we have said before, if you are fully immunized, the Pandemic is over, for you.

And the US is very sharply following the path demonstrated by Israel.  Remember that Israel also started seeing COVID cases plummet as immunizations reached 30%, 40%, 50% of the nation.  By the time Israel hit 55% immunization, COVID spread nearly ceased, and since then Israel immunization rates have been stuck at about 55%.  But COVID spread has remained nearly zero.  The US is looking the same.  Our rates have been dropping since we hit 30%, and now 40%, as noted.

This means that we can still hope to see COVID transmission become negligible when we hit 55% immunization too.

What this means is that the US may enter the End of the Pandemic as we go from 40% fully immunized (now) to 55% fully immunized (June 20).

An Asia/US Flip

All through 2020, we observed how East Asia had stopped the spread of COVID while the US and Europe utterly failed to contain the spread.  The results have been dramatic.  Taiwan is a nation of 23.5 million people, and to date have suffered 35 deaths.  If we had identified all infected and isolated them outside the home starting in January 2020, we would have lost about 500 to COVID, instead of 588,000, astounding, crushing, inexcusable.

But now we see a flip.

Where East Asia embraced identification and isolation, the US is embracing immunization.  As noted just above, we are at 40% of the entire nation fully immunized.  With the exception of Singapore, which is 28.3% immunized, almost all East Asian nations are at about 10% or far fewer.

We leave it to others to explain these trends, but they are very durable and compelling.

Bottom Lines

1. The COVID Vaccine is safe for adolescents, it does not cause myocarditis.
2. The COVID Vaccine is ending the pandemic.
3. We are at 40% of the US fully immunized
4. As we approach 55% fully immunized, the hope remains that the Pandemic will actually come to an end in the US, for now.

My Takeaway – In One Sentence:

The COVID vaccine works, it is safe, it is delivering an End to the Pandemic, so if you are not yet immunized, and can be, please, please, please get the vaccine, lives hang in the balance.

To your health,
Dr. Arthur Lavin