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.
• 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.
• 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.

Vaccinate & Test

The facts are very clear and desperately urgent:

1. Delta spreads in poorly vaccinated populations, and is doing so right now.
2. Through no choice of their own, every child 11 years old and younger is at risk.
3. The only real hope our children have, until the vaccine becomes available, is to have every adult do all we can to stop the flow of Delta.
4. By far, our best hope to protect all our children is to have every person 12 and up vaccinated.
5. The other steps all of us can take to protect all our children include:
   • Test frequently to find the infected and keep them out of the classroom
   • Mask in the classroom
   • Social distance in the classroom
   • Ventilate the classroom
   • Pod classrooms

On September 8, 2021 the President of the United States essentially rang the alarm about the Delta epidemic, specifically citing the threat to our children’s lives and the urgency of all of us to act to vaccinate and test.

Here is the situation:

• 80 million Americans who can be vaccinated against COVID  have chosen not to, putting all our young children at serious risk.
• In states where COVID vaccination is low, children are suffering COVID and filling intensive care units, states where vaccination rates are high, the children are spared this dangerous suffering.
• Frequent testing can help stop the flow of Delta in children.  If we know who has it and isolate them from others, it simply will not spread so well.

And here is what is now being done:

• The United States is going to require places that employ 100 million workers to be 100% immunized, or tested weekly.
• The 2nd largest school district in the United States, in LA, is implementing the requirement that every child 12 and up be fully immunized, or not attend school.
• The United States is going to make home, rapid tests available at cost through Amazon, WalMart, and Kroger.  Every family will have access to these tests.

Putting it all together, it is time for us all to agree to do the following:

• If you, or anyone in your family, is 12 years old or older, and you are not yet vaccinated against COVID, you must do so, today.  The President of the United States put it plainly:  “We have been patient but our patience is wearing thin, and your refusal has cost all of us”   Anyone thinking about not getting COVID vaccination must know that lives are being lost today by this decision, and lives of our children are truly being put at risk.
• It is time to embrace frequent, home testing.  The soon to be available, next week, at-cost, highly reliable, home rapid (antigen) tests open the door to testing before school, perhaps for all children 11 and under frequently.  Consider daily testing, or at least weekly.  Certainly any child with a cold or fever.  We would encourage all families to move to wide use of  home testing.  No longer will families need to rely on our PCR test which takes 36-48 hours for results and an appointment, we need to move to cheap, at-home testing, that takes 15 minutes for results.

And our schools need to:

• Make COVID vaccination mandatory for anyone working or attending the school who is 12 years old or older.  LA has done so. Case Western Reserve University and so many colleges have done so.
• Schools should observe basic quarantine efforts.  All those contagious need to stay home until no longer contagious.  All those who have been within 6 feet of a known infected person needs to be kept home, out of school, until proven to not have caught COVID.
• Classrooms need to be well-ventilated.
• Podding and social distancing remain very, very important.
• Virtual teaching needs to remain a good option until the COVID threat to children ends.

A Word on Rapid, Antigen v. PCR testing

There are two tests available to find out if you have active COVID infection.

One is the PCR test. This finds out if you have the genes, the RNA, of the SARS-CoV-2 virus that causes COVID on your throat or nose. This test is highly reliable if positive.  So much so that if your PCR test is positive, you really should conclude you have COVID.  The test can be wrong if negative, especially if you do the test too soon after being infected.  Say you somehow know you got infected with COVID on say June 1.  If you do a PCR test on June 2 it will be negative almost 100% of the time.  Because it takes about 5 days for enough viral RNA to build up to be detected.   The PCR test cannot be done at home.  It can obtained in some offices, but most hospitals and offices need 36-48 hours to report the result.

The other is the antigen test.  The word antigen simply means any molecule the immune system might recognize and react to, usually a protein.  The antigen test is rapid, about 15 minutes.   It works like a pregnancy, put the sample on a card and if a line lights up, you have a positive test.  Easy to do, easy to use, easy to read.  The antigen test can be falsely negative in those who really do have COVID if it is done before 5 days after infection, just like the PCR.  It does turn positive in more people that do not have COVID than with PCR.  So, if your home test is positive, you should test again, and if it is positive twice, you almost surely have COVID.  But if it is negative, and done 5 days or more after you think the infection occurred, you likely do not have COVID.

The provision of less expensive, extremely easy to get rapid home antigen tests is indeed a game changer.  We need to really re-think testing.  No longer mainly a doctor office event, but a home event.  No longer occasional, but now frequent.  We need to think about testing any child with any cold or fever symptoms before going to school.  We need to think about testing any child 11 and under, or anyone 12 and up unimmunized at least weekly before going to school or work.

Bottom Lines

1. We are now truly in a pandemic we have chosen to suffer.
2. We can end the pandemic now, with vaccination and testing.
3. Everyone 12 and up currently unimmunized needs to get COVID vaccine today.  Refusal to vaccinate is truly costing lives, even the lives of our children.
4. We need to urgently re-think testing, we urge all families to look for when Amazon, WalMart, and Kroger will make good, home, rapid, at home testing with antigen test kits, and get a large number of them.  We endorse having you test your child with a cold or fever, but really any unimmunized person prior to going to work or school at least weekly.

One Sentence Takeaway:

Enough is enough, let us stop the suffering and end the threat to those we love- get vaccinated, embrace home testing.

To your health,
Dr. Arthur Lavin