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.

A Special COVID Valentine Moment- A Break in the Pandemic

But Not all Good News

The update today is brief and mostly good.

The number of new cases in our region are plummeting, down to levels that suggest there simply is not very much new COVID circulating, right now.

We have been tracking the level of COVID flying around by the number of new cases per 100,000 in our area.  At the peak of last year’s winter holidays (2020-21) we hit a high of 120 per 100,000.  Omicron jumped Ohio up to 235 by mid-January.  But since then the flow of COVID has thankfully dried up, down to 28 today, and still dropping rapidly.

In Cuyahoga County the latest report tells us that COVID has ceased spreading in our County almost entirely with our per 100,000 rate down to 1.3!

With COVID spread halting, for now, we of course can be less concerned about catching it!   This is great news for everyone here.  It is good news for the immunized, who can walk about with even less worry, safe from severe illness, now safe from even catching it.

It is good news for the unimmunized, particularly the unimmunized adults, who are still dying at a shocking rate.  Even today, the US reported nearly 2500 people died of COVID yesterday, almost all people who chose to be at risk of dying by choosing not to be immunized.  This is a very, very high number, if it was sustained for a year, we would lose nearly 1 million more lives, just in the US.   The good news is that as the numbers of new COVID infections drop, the death counts will soon fall as well, but not for a few more weeks as the severe illnesses already caught come to their conclusions.

The Disappointing Delay of Starting the Immunization of our 6 month to 4 year old children

In our last posting to Real Answers, we were excited to share the news that the Pfizer data supported proceeding with the first two of three doses of COVID vaccine for 6 month to 4 year old children.

The most recent news is that Pfizer has decided to wait to ask for approval until data on all three doses of the proposed 3 dose series are in hand.

A quick reminder.  Everyone age 12 and up gets a total of 30 microgrbams, or mcg, of COVID vaccine in each dose.  Children ages 5-11 get 10.  Pfizer decided to see if an even lower dose was sufficient for babies, toddlers, and pre-schoolers.  So they tested a 5 mcg dose.  Two doses of that very low dose was not protective enough, so they moved to make it a 3 dose series.  The third dose for these young children would not be a booster, it would be part of their initial series.

Well, the 2 doses of 5 mcg turned out to indeed require a 3rd dose.  All indications are that these first 2 doses are as astoundingly safe as COVID vaccine in older kids, and that the third dose will get our young children full protection.  But instead of this process starting this month, it is now having to wait until trials on the 3rd dose are complete, due in April.

Bottom Lines

1. It has been a very sad and challenging 2 years, let us celebrate the retreat, for now, of COVID.  It is a very big deal that cases are dropping to such a tiny number.
2. We fully support withdrawing some safeguards while COVID transmission rates remain negligible, but stay tuned for possible new surges.
3. It is disappointing that our children ages 6 months to 5 years must now wait until April to begin their COVID vaccine series, Pfizer wants data on all 3 of the recommended 3-dose series in hand before seeking approval to start.

My One Takeaway Sentence:
The main takeaway remains the same:  GET VACCINATED, GET VACCINATED FULLY, GET VACCINATED NOW.

To your health,
Dr. Arthur Lavin