• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    COVID Update November 16, 2021: The Plague That Will Not Go Away; The Door Opens to Protect All Students From Kindergarten Up

    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 Delta.
    • 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.
    • 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.


    Anyone had enough of this plague?  I know I have.  We all have detested it from its start, and felt different fears and dreads at each stage of the progression of the COVID Pandemic.  We are all in a new place with this plague now.  Different enough that I have had trouble getting my bearings on where we are, and where we are headed.

    As readers of Real Answers know, this is a bit unusual for me, across the last 2 years there have certainly been times of great uncertainty.  The start of the COVID Pandemic was such a time, no one knew what to expect, no one.   But once the virus announced itself, once we had learned how it spread and what stopped its spread, once a great vaccine was created and used, the fog was created by us, not the virus.  It became clear what to do to stop this Pandemic, and crushing to see it not happen.

    But then the original variants of SARS-CoV-2 began to be fully tamed by the magnificent mRNA vaccines.  You will remember me writing about how Israel jumped ahead reaching 55% vaccination rates, and seeing transmission, essentially, cease.  And then the same being seen across the world, and when we hit about 45-50% in the US, in May and June, our COVID cases dried up.  It looked like if no new variant appeared the plague would really end.   By June, masks were coming off, we gathered once again, and the vaccine held, transmission came close to ending.

    Until Delta.

    Delta was a variant that could kill with only a handful of viruses landing on you.  It spread madly.  It crashed through the wall of vaccination that kept it from spreading.  Forever, I will be grateful Delta never widely crashed through the wall of vaccination that kept you alive.  And with these properties in hand, Delta spread across Planet Earth, pushing out the original variants, taking over, and making a hash of any region that dared not achieve 80-90% immunization rates.   As Dr. Fauci said of Delta, if you are not immunized, COVID will find you.

    Gone were super spreader events, gone hot spots.   Dr. Fauci’s prophecy came true, in every state, in every neighborhood, in every nation.  Don’t vaccinate, you will likely get COVID.

    And so now we watch as Delta COVID finds every patch, every area not immunized, and spreads like wildfire.  Initially it did what all fires do, burn hot, and burn fast.  From India to the Netherlands to here in Ohio, Delta pounced surges flared, and then the numbers plummeted.   Let’s look at my favorite metric to tell me if this damn plague is still spreading, how many new cases appear every day per 100,000 in a region?

    In India, there was curiously not much COVID til Delta.  It ran nearly 0 cases at 1 case per 100,000 per day.  Then Delta hit and that number jumped from 1 to 25 by May.  Then it dropped, all on its own.  By June 25 it had dropped in India back down to 3 and today is back to near zero at 0.8.   This is how I anticipated Delta would be everywhere, and until last week or so, it was.

    Here in the US, we had our worst raging surges around Christmas and New Year about 1 year ago when our number soared to 120.  But then our number dropped to 3.6 by the end of June, remember those great days?  Then Delta came.  The American Delta surge roared, maxing at 51.9 on September 13.  Then came our turn to drop.  And we did, as predicted.  We dropped to 21.7 on November 3.   And then something unexpected happened. Our drop stopped.  In many states the drop turned into a new small surge.  Across the US we have seen our number rise slightly now it is at 23.9

    But look at Ohio.  Our Delta number peaked at 61 on September 15, right in line with the US overall.  And like the rest of the US we then dropped, hitting our low of 28.6 on November 1.  But since November 1, our surge has been more awful than across the country.  We have really climbed and now sit at 40.0.  Why?  Since November 3 when the drop was clearly halting and this week when it clearly began reversing, I have been puzzled.  And still am, but here are some clues.

    First, you will note I have not quoted trend lines for rates of deaths by COVID.  Total numbers yes, but not rates.  And that’s because the number of infections always tracked parallel.  More cases more deaths, fewer cases fewer deaths.  But not now.

    Across the whole pandemic that pattern was clear across the US and Ohio, but not now.   Now cases are climbing very slowly in the US but deaths continue to drop.  And in Ohio, where case numbers have gone from 28.6 to 40, deaths have wonderfully plummeted.  We are at nearly 0 deaths, our lowest since the pandemic again and during our near cessation in May and June.  This may reflect the fact, and likely does, that deaths follow 2-3 weeks after cases, so we will see.   But my current hunch, and it is not proven, just a hunch, is that our numbers are rising because Delta does infect, but to a massive degree does not kill.  So now we can see cases surge without deaths surging, at least as much as before vaccination.

    But in any case, around the world, even highly immunized nations are seeing a surge in COVID.

    Keep in mind though that as getting infected and getting sick enough to die begin to diverge, the future deaths from COVID will more and more be limited to those who chose, and chose for their children, to not get vaccinated.

    Stay tuned to Real Answers.   I have no doubt we will know, and hopefully soon, what this latest surge is about, so we can end it.

    Of course my greatest fears are one viral and one human.  The viral one is that a new variant that not only infects but kills the immunized will emerge.  Keep in mind we have the means to create a new effective vaccine should that happen, but still a bad nightmare.  The other is that millions will persist in refusing to help end this nightmare now by simply getting the shot!

    The Door Opens to Protect All Students From Kindergarten Up

    A COVID UPDATE cannot be complete at this time without celebrating a major moment in our fight against this killer.  With the approval of the Pfizer COVID vaccine for 5-11 year olds this month, we can finally say to all our children in elementary school up, we can protect you.

    For millions of parents watching this killer stalk the world, it has been a true torture watching everyone but their children get to safety.

    But this November, November of 2021, we took our 5-11 year olds under our wings and said, yes, you too can be safe from this virus whose harms we still now really nothing about in terms of effects more than 2 years after infection.

    One of my proudest moments last week was welcoming children and their parents to their office and shouting out, “Welcome to history, welcome to safety, you made it!”  And with a tiny jab of just 0.2 ml, that child now stepped into a land where, so far, the virus can do little harm.

    How little harm?  We now know the immunized are 40 times less likely to die of COVID than the unimmunized.  That’s a big difference and I am so glad it is here for the 5 and up.

    What about 0-4 now?  At this point firm dates are not in hand.  But it looks like that when all is said and done, the lowest age will be 6 months.  We do not know if the next approval will be 6 months to 4 years, or a subset like 2-4 year olds.  Pfizer had talked about starting the approval process at the end of this month, but I heard that in September and perhaps October, not recently.

    My hope is that at least the 2-4 year olds will be approved in December, maybe even younger, and all 6 months and up early in 2022, but we will see.

    Bottom Lines

    1. Real Answers with Dr. Lavin continues, now in a new home, continuing seeing past posts at drlavinrealanswers.com
    2. We are in a not yet fully understood surge of COVID here in Ohio.  We hope to know why soon and really hope to end it soon.
    3. Until this surge ends, protect yourself whether immunized or not.  Try to avoid indoor gatherings, wear masks if you do.  Get tested a lot.
    4. MORE THAN ANYTHING ELSE, GET THE SHOT!!  It is our only path to really end the madness.
    5. Finally, hooray for our Kindergartners up to Middle School, they join the Middle Schoolers, and High Schoolers, and College Kids as the children we can get protected with COVID Vaccination!

    My One Takeaway Sentence:

    This killer has killed too many, hooray that all our kids 5 and up can be protected, now it is up to all of us to get everyone vaccinated to end the dying.

    To your health,
    Dr. Arthur Lavin


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