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 (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.

On this 246th birthday of our nation, the United States of America once again celebrates the hope for us all to celebrate life, liberty, and the pursuit of happiness.  And on this 4th of July, we also celebrate the 159th birthday of, as Abraham Lincoln put it, “a new birth of freedom” because the other event of the 4th of July was the victory at Gettysburg.

The moment calls for us to pause to consider the considerable successes of two major responses to the COVID Pandemic in America.  One succeeded in saving lives.  One succeeded in costing lives.  Both movements are global in nature, but we will concentrate on how they have played out in our nation on our national birthday.

The American Success in Saving Lives

Across the world, and in America, the COVID vaccine stands out as the greatest triumph in saving lives from the deadly threat of COVID.

This was not an overnight success, it took 30 years of hard work in many, many laboratories, universities, and companies, to find the right path to harness the power of our genetic code to safely have our own bodies make the protein to have our bodies become strongly immune to any infectious disease.

Science has of course had other successes.  In every instance, a science helped make life better only by three steps happening:

1. Have a new idea.
2. Test the new ideas to see which few work and which can be engineered into products that safely save or enhance lives.
3. Implement the new technology.

Take the example of a scientific breakthrough that has few critics.  Eyeglasses.  Humanity spent most of its existence without any idea that eyeglasses would work or could even exist.  And so whoever developed significant near-sightedness or far-sightedness would simply not be able to see.  That included the vast majority of humans able to reach the age of 50 and beyond.   No one could possibly use eyeglasses before someone had the brand new idea of using glass to correct focus.  Even if people dreamed of correcting blurry vision, glasses would not be able to be used until some group of people tried out the idea, seeing what worked and what did not.  Finally, none of us would be able to use this nifty idea unless humanity bothered to take the steps to find out how to make millions of them and make them available to those interested.  The success of eyeglasses has been profound.  And transcends all political and religious beliefs.  Everyone who needs to see and wants to see but cannot due to blurry vision uses them, liberal, conservatives, science skeptics and scientists, atheists, and religious people.

It is just so with the mRNA story.  The main difference is that eyeglasses are pretty easy to understand, and eyeglasses have few possibilities of unintended harms, aka, side effects .  Eyeglasses are one of the most visible of scientific inventions.  mRNA is invisible to the eye, and to a large degree, to the mind.  One has to master some details of how genes work to even know what the abbreviation mRNA really means.  But even so, the story of mRNA vaccines is no different than the story of eyeglasses.

Before someone thought of using mRNA to make vaccines, no one could even imagine it.  Then one day, someone had that thought.  Then scores of people had to try out all sorts of ways to make it work and safely, nearly all of which failed, until, 30 years into the testing, a safe and workable technique was developed.   Only then could the third and final step in any invention take place, sorting out how to implement it across the world.

On this 4th of July, we all should celebrate this particular success!  And the reason could not be more compelling, the idea, creation and distribution of this invention has saved an astounding number of lives.

Just through November of 2021, the CDC has calculated that if 30 years ago no one had come up with this idea, and over the last 30 years no one had worked to make it work, and in the last year or two, no one had bothered to make it available to everyone, one million of us would not be alive this 4th of July to barbecue, and celebrate with friends and family.

This is something to once again pause and give thanks, that human ingenuity and commitment to inventions that save lives, saved one million of us this time!

And this year, 2022, the COVID vaccine has already dropped the chance one of our children ages 5-11 would be killed by this horrible virus 10-fold.   That’s right, children whose parents have agreed to protect them enjoy a chance of surviving a COVID infection that is 10x that of children whose parents have chosen the other path, which we will now describe.

The Tragic Success of the Other Path in America

Just as powerful, and tragically, just as effective, have been the efforts to use arguments, not facts, to confront facts about vaccines.   Questions about vaccines are of course always welcome, and go back to the very start of the invention of immunization.  The first immunization was the smallpox vaccine.  And when the idea that a doctor would do something to someone who was perfectly healthy, a predictable howl was raised.   But the forces against vaccines lost that round, and by winning, the forces in favor of using this helpful tool actually did something no person, no nation had ever achieved before, the actual elimination of the scourge of smallpox from infecting anyone again.

That triumph culminated in 1978.  Since then, no human on the planet has suffered even a single case of  smallpox, which killed about 30% of those infected!  It is now calculated that during the years 1980-2018 that somewhere between 150 million to 200 million lives have been saved because there was no more smallpox!

We need to pause once more, because those who thought it would be a good idea to stamp out smallpox prevailed over those with doubts about vaccination, as many as 200 million people are alive now who would have been dead.  That is nearly 20 times the entire population of Ohio that would have been condemned to death by the musings of those who doubt the value of immunizations.

But smallpox seems long ago, let’s get current with another immunization, one where the forces that oppose the idea of immunization are having much better success than with smallpox, the vaccine called HPV.  HPV is a vaccine to stop the virus that causes warts and the vaccine stops only those wart viruses that cause genital warts, and cancer.   The forces that oppose the idea of vaccination have been so successful in getting folks to doubt and even refuse HPV for their adolescents that in just the years of 2013-2019, about 25,000 people got cervical cancer who wouldn’t have if they had gotten the HPV, and of those about 5,500 died of cervical cancer solely because of resistance to vaccination.

The opposition to vaccines has come a very long way since the days of smallpox vaccination.   The forces against vaccination totally failed to stop humanity from saving vast numbers of our lives.  But they are much better at it now.  The HPV story makes clear that real lives are lost when these doubts win.

Now we come to the second story of American success in our experience of COVID.  But this success is one for death, not life.  It is the wildly powerful success of the well-funded, highly organized movement now called anti-vax.   The opposition to vaccines over history never really took over any major political party in America or held sway in laws across the land until now.  But the anti-vax movement of COVID has achieved a level of success never dreamed of in prior actions to block us from being protected, defining many political campaigns, being expressed in law, and loudly proclaimed every second of every day.

When I began practice as a pediatrician, it was routine to see children achieve levels of vaccine coverage exceeding 95% for various vaccines like tetanus.  Those numbers are dropping, and none are lower than for COVID vaccination.   We now live in an American moment where a vaccine that can drop your child’s chance of dying by COVID 10 times, being refused by 75% of parents!  As of this moment, 75% of children who are in the age range of 5-11 years old, have parents who have decided not to share this protection with them.

I do understand the power of doubt.  In contrast to many powers, it is so easy to conjure up.  All one has to do is repeat a question.   And if the question is the right one, the flame of fear can easily be ignited.  It really is as easy as starting a forest fire.  Just light a few flames of fear, and the forest of protection that immunizations always offer, goes up in smoke.

And I understand the range of the impact of the anti-vax movement.  I know that it’s only a small minority of families that have decided to never immunize their child against any infection, ever.  But this movement has touched the lives of now a majority of families when it comes to the COVID vaccine.  I have even heard this fire of fear burn in the minds of fellow pediatricians.  It’s a ripe field, after all, children do pretty well with COVID.  Almost everyone who has a child with COVID sees someone with a mild illness get better with no trouble.  So why worry?   And in the face of whispered worries, that few know are being pumped into our social media information infrastructure, what chance does a child have that their parents will not succumb to even a bit of doubt?

I appreciate these dynamics, and acknowledge that the greatest power of good science is after all doubt.  Good science always wants to test a claim, and try its hardest to prove it false.  But now and then, and in the case of COVID vaccine this is such a moment, science has exhausted all its efforts to prove a new idea is not what it claims, and the new idea takes life, and saves lives.

The COVID vaccine has now been given over 12 billion times, and its safety has been nothing short of astounding.   There are essentially no deaths that can be blamed on anyone getting this vaccine.

That makes it vastly more safe than Tylenol or Motrin, which people seem to take without much worry at all.

Now we come to the greatest power of the success of the anti-vax movement.   Even though vaccines have saved, just in the US, over 1 million lives, the anti-vax movement’s success is so strong that it has been able to convince enough people not to get COVID vaccine that as of May of this year, 318,981 people have died for refusing the COVID vaccine and some of these people were children.

That is a powerful success, imagine the power of a movement that can talk over 300,000 people to give up their lives for it.

On This 4TH of July, Let Us Choose to Protect Ourselves From Death by COVID

The connection between health and the 4th of July may run deeper than you think.

I was deeply honored recently to review a manuscript of a book written by the great Yale Professor of History, Timothy Snyder.  The book, Our Malady, reviews his own personal experience of having appendicitis, how close to death he came because of problems in our health system.  He puts forward the powerful notion that a working democracy must solve its citizens’ most important problems, that’s the whole point of a democracy.  I added some thoughts on how a good, close, working relationship with your doctor should be the foundation of any health system and was credited in the Acknowledgement section of the book.

The point is that the Declaration of Independence and the victory at Gettysburg, which we celebrate today, were all about the idea that a nation could endure even if oriented completely towards responding the very real needs of very real people.  When Lincoln stated our government should be “of the people, by the people, and for the people” he really meant it.  He really meant that each of us has to be true to our needs and act on them.

Bottom Lines

1. This 4th of July marks the 246th birthday of America and the 159th anniversary of the victory at Gettysburg.
2. And this 4th of July, as we celebrate our nation’s existence, it is good to consider two astounding successes in America during this pandemic.
3. The first is the success of science.  A thought led to 30 years of work culminating in a vaccine that could halt the ability of the COVID pandemic to kill such vast numbers of us.
4. That success has saved over 1 million lives already, just in the US.
5. The second is a more deadly success, it is the rise and bold success of the anti-vax movement.  A movement that lives on questions specifically designed to ignite fear and doubt, not to search for answers.
6. This success has achieved the loss of over 300,000 lives to COVID through May of this year.  We now know that choosing not to get the COVID vaccine has cost 318,981 lives so far.  That is a powerful movement, a tragic movement.
7. The anti-vax movement now raises doubts across families about protecting their children from the deadly COVID pandemic.  It is the case that children get COVID more mildly, but the virus can still kill.   The vaccine can still protect.  The COVID vaccine is now known to drop the chance of a child dying from COVID in the ages of 5-11 by 10 fold!
8. The American experiment asks whether a nation can dare to learn together, dare to find answers to their problems, and dare to put them into action.   This 4th of July, enough of our nation said yes to save 1 million lives, and enough of our nation said no to lose over 300,000.
9. Please join the success of the COVID vaccine, get all our children protected, the vaccine is now available to every child 6 months and older.
10. If you ever wonder, what would I do if my child was a young baby, would I have them COVID vaccinated, the answer is yes, all my young grandchildren are COVID vaccinated to the fullest extent possible, including one baby.

My One Takeaway Sentence

This 4th of July, I cannot think of a better way to celebrate our nation’s existence, than to embrace good solid facts that offer everyone one of us, now ages 6 months old and up, real, safe, wildly effective protection from death by COVID.

To your health,
Dr. Arthur Lavin