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    COVID Update December 23, 2021: Good News on COVID for 2022; Maybe a Healthy as Well as Happy New Year?

    By Dr. Arthur Lavin


    • 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 (genes and protein coat), and on it goes.
    • Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines. Variants that substantially increase harm are now listed by Greek letters, the most troublesome one now is Omicron.
    • 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.
    • PCR Test–  swabs the nose to detect the genes of the COVID virus.  The genes if detected are almost certainly there, but they can persist long after contagion ends.  Very few false positives, positives can be trusted.
    • Antigen Test (the home kit)- swabs the nose to detect the proteins on the coating of the COVID virus, the spike proteins.  If it does not detect those proteins, you are almost certainly not infected, negatives can be trusted.  These proteins are also on the coating of many common cold viruses, so one positive test may indicate you have a cold rather than COVID.  Two positive home tests though reliably indicate you have COVID.
    • 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.

    Good News on COVID for 2022
    Maybe a Healthy as Well as Happy New Year?

    If you are like me, the current explosion of Omicron COVID right now has been beyond discouraging- it is upsetting, frustrating, frightening, maddening.  When will this dread end?  How bad will this 4th surge be?  Why did it have to happen around the holidays?

    We are seeing the tragedy of the Omicron explosion up front, as our office joins all places of health care in trying to respond to a rather massive increase of need.  Each day we hear of more stories of lives disrupted and put at risk.

    Last New Years I wished everyone real hope that 2021 might be the year we end this scourge, but it was not to be.  The release of vaccines did in fact offer us all the chance to end COVID here in the US, but nearly half the nation chose not to end COVID, and it continues.

    But this year, we approach the New Year with 4 items, each of which could help us truly end the danger this virus has put everyone of us in.

    Here are 4 pieces of really rather extraordinary good news, the sort of developments that could make 2022 a truly Healthy New Year:

    1. Massive distribution of rapid COVID testing
    2. Great preliminary news on the severity of Omicron
    3. A truly powerful pill to keep COVID from hurting anyone
    4. A new vaccine from the US Army to protect everyone from all dangerous coronavirus infections

    Here is the scoop on each:

    Massive Distribution of Rapid COVID Testing

    Since the start of the pandemic, readers of Real Answers have been informed that short of a treatment to stop the virus, the only path to end the spread was to identify everyone infected and isolate them.  That remains true today.  Some nations have done this and have astoundingly less COVID.  One example near and dear to my heart is Hong Kong a city of 7 million people whose total number of deaths from COVID is currently 213.  Had the US simply done what Hong Kong did, our total number of deaths would be about 10,000, not 800,000 of us dead.

    Central to this strategy is the wide availability of reliable testing.  Many public health experts have long called for the US to make rapid tests so widely available that anyone could be tested at home anytime.

    That day is now being delivered to the nation.  Starting in a few weeks, 500 million rapid tests will be distributed across America.

    And the flow will continue.  Imagine anyone being able to test prior to going to work or school for any suspicion of having COVID.  No more searching for home kits, or waiting for appointments.  You have reason to think COVID is present, test.  If you have it stay home, if not go to work or school.  This strategy can sharply cut into the spread of COVID and dramatically weaken the pandemic’s grip.

    Stay tuned for exactly when home testing kits will be available to each of us!

    Great Preliminary News on the Severity of Omicron

    In our last several posts, we have made clear that every epidemic presents three key questions:

    • How well does the virus spread?
    • How deadly is the infection?
    • How well do our vaccines and treatments protect us?

    We have shared the staggering degree to which Omicron spreads, and it continues to explode.  One hope to consider is that when viruses spread so wildly, they often burn through a population rapidly.  Let us hope Omicron, as it explodes across our nation, and right here at home, it goes away as quickly as it arrived.  Cuyahoga County has a higher rate of COVID right now than all but 2 other counties in the US, but the Omicron surge is powerful from Vermont to Wisconsin.  Very early evidence from an early place of its outburst, S Africa, does indicate there is reason to hope that it surges quickly and fades quickly.  Let us hope!

    But beyond just hoping, on the second question, how deadly is Omicron, the news from many nations is coming in, and it is darn good.  From the UK to Denmark to South Africa, reports are that if infected with Omicron, your chances of ending so sick you need a hospital, or dying, are 60-80% less than prior variants.  Should these data hold up here, that would offer us a 60-80% reduction in the chances of getting very ill or dying from COVID, and that would be an extraordinary bit of good news!

    We need some luck on COVID, and if the current variant turns out to cause substantially milder disease, that would be excellent luck.  Perhaps aided by widespread immunization, but in any case, welcome relief.

    A Truly Powerful Pill to Keep COVID From Hurting Anyone

    It is official, it is time that everyone learn this word: Paxlovid.

    Paxlovid is the name of a new drug that works so well in treating COVID that the trials had to stop, to avoid the unethical action of denying those in a trial access to a medication that is now known to work so very well.

    Paxlovid is a pill that if taken twice a day for 5 days within 5 days of onset of COVID symptoms, will drop your chance of ending up in a hospital or dead from COVID by 89%.  Take a pause.  Imagine a world in which about 90% of all the hospitalizations and deaths from COVID cease to happen.  Let’s consider again our loss of 800,000 American lives.  If we had Paxlovid available at the start of the pandemic, that number would be 80,000.  It would have saved 720,000 lives!

    More to the point, it will save about 90% of lives that would be lost without it.

    It is approved, but is complicated to manufacture, so the roll out will take a few months.  But the US has bought 10 million doses which should be available by this Spring.

    How does it work?  It blocks an enzyme that COVID uses to assemble its famous spiked protein coat.  This strategy has been wildly effective to treat HIV/AIDS and Hepatitis C, and now it comes to save us from COVID.

    Read the use carefully.  If you have COVID and develop any symptoms, and take this medication 4 days later, it will not work very well.  You must take it within 3 days of the first symptom for it to work as well as it can.  This makes the availability of testing even more important.  If it is easy to test widely and frequently, more people will know their symptom, any symptom, is from COVID and able to get those 30 pills of Paxlovid to take 3 pills twice a day for 5 days and drop the chance of hospitalization or death by 89%.

    Initially it will be important to focus use of Paxlovid to those most at risk of hospitalization or dying, a complex set of choices, but in time we look for 2022 being a year in which COVID is converted from a threat to a treatable disease!

    A New Vaccine From the Us Army to Protect Everyone From All Dangerous Coronavirus Infections

    One fact that nearly everyone has heard about is how the coronaviruses have spike proteins.  That’s how the viruses got their name, the spikes form a deadly crown, or corona, on the virus.  All coronaviruses have these spikes, and there are many besides COVID’s SARS-CoV-2.

    Remember the first SARS, it hit Hong Kong, China, and several other nations, including Canada.  Then there was MERS, an extremely deadly form of coronavirus that was mainly in the Middle East, and not that contagious.  And of course, our COVID has many variants, including Delta and Omicron.

    Well, the US Army has announced success in initial trials on people of new type of vaccine.  The idea is that you take a very tiny ball and stud it with 24 different coronavirus spike proteins.  And then, let’s see, does this vaccine protect against more than one type of coronavirus?  The answer that it does, and does so well, we may have a vaccine that protects very strongly against all the nasty coronavirus infections out there.

    Now imagine with one shot series that would render you unable to be infected by any dangerous coronavirus, including all the relevant variants of COVID?  That is quite a window of future hope for 2022!

    Bottom Lines

    1. Omicron has ruined many days for millions already.  It is still exploding and doing so very well here at home in Cuyahoga County.  It feels like 2021 is ending on a very discouraging note.
    2. But as we end 2021, the dawn of 2022 brings with it 4 very concrete, each very powerful reasons to hope we will quash COVID once and for all in 2022, reducing more to a nuisance than mortal threat.
    3. First is the coming distribution of 500 million at home COVID tests starting in a few weeks!  Soon testing will be so much easier and widespread, we will be able to know if we have COVID before going to work or school.
    4. Second, preliminary but widespread data suggest that Omicron may be dramatically milder than Delta, with chances of being hospitalized or dying 60-80% less.  We do not have that data here at home yet, but let us hope it holds here, it could make 2022 a far healthier year.
    5. Third, welcome to Paxlovid.  This pill, if taken 3 pills twice a day for 5 days, within 3 days of onset of COVID symptoms can drop your chance of ending up in a hospital or losing your life, by 89% and 10 million doses will be distributed by the US Federal government starting in 2022.
    6. Fourth, the US Army announced the success of a new coronavirus vaccine that can protect against many dangerous coronaviruses, and COVID variants, all at once.  Further trials will tell us of this great step forward will be in use in 2022.

    My One Takeaway Sentence:
    This pandemic has been a true catastrophe, and these 4 bold new steps to tame the scourge are coming just in time.

    And, in the meantime- GET FULLY VACCINATED ASAP, Omicron is spreading, the vaccine is a tool we have NOW to save your life and the lives of all you love.

    To a Happy and Hopefully Healthy New Year,
    Dr. Arthur Lavin


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