In Control?

Another quick update for you this week.  Will touch on vaccines and variants.  Think we are in control at this time?

Greensky Bluegrass performing “In Control”  in Eugene, Oregon (3/19/2015)

Just The Basic Facts (Can You Show Me Where It Hurts?)

After months of watching the numbers improve, we are witnessing a different trend emerging.   The CDC reported an average of 26,306 cases daily over the last week.  This is markedly lower than the peaks in January in which daily case rates exceeded 250,000 per day.  However, it represents a 69.3% increase in daily case rate compared to the week preceding it.   Hospitalizations continue to be fairly low with a 7-day average of 2,794 nationwide.  Again though, this average is higher than the week preceding it by 35.8%.  Lastly, the nation lost an average of 211 lives per day this past week.  This represents a 26.3% increase as compared with the rate one week prior.  Remember, hospitalization and death rates lag behind increases in case rates by several weeks.

So those are the facts we are working with this week.  What does it mean?  Have we lost control?  Where does it hurt?  Will circle back to address these questions, but first will touch a bit on variants and vaccinations.

Billy Strings with Umphrey’s McGee in Asheville, NC performing Hendrix’s Voodoo Chile.  For more typical Billy Strings, click here.

Variants

The Delta Variant

Unless you have been completely enjoying your summer technology free (you clearly are not), you have heard about the delta variant that has become the dominant strain in the United States.   This variant spreads quicker and hits harder than prior iterations of COVID-19.   There are increasing reports that vaccinated individuals are contracting this variant as well which is leading to further concern.  This includes members of the NY Yankees, and led to cancelation of a game this week as a result of multiple players contracting the virus.  Granted, that may be to their advantage considering their play of late.

Studies are emerging demonstrating that serum from individuals who either recovered from COVID-19 or were previously vaccinated was less effective at neutralizing the delta variant.  These studies are further stoking the fear that this variant could be of higher concern to all.

So before we go off the deep end with the delta variant, other data is quite reassuring at this time.  For the month of May, there were 18,000 deaths in the United States attributed to COVID-19.  Of these, 150 deaths were among individuals that were completely vaccinated.  No, I did not forget a zero or two.  17,850 of the 18,000 deaths were unvaccinated individuals.  Similar trends are being noted in hospitalized patients – there are very few vaccinated individuals among them.  Unless these parameters start to reveal different data, while the delta variant may be more dangerous than others, this danger is only applicable if you have not yet taken the vaccine against COVID-19.

Another aside on folks messing with numbers…..it is being reported that younger folks are now making up a higher percentage of those ill and hospitalized.  This is not shocking for a simple reason – they are the least likely to get vaccinated.  The elders of this country took their shot, much like they took their polio shot as kids and said “thank you.”  Since the vaccine has protected them, that only leaves young vulnerable people.  And while the delta variant may be causing more morbidity among young people they have a simple solution, and that is to take the vaccine as well.

The Epsilon Variant

No, I am not kidding.  And I hope that we won’t need to be talking more about this one in a few weeks.  There is another new variant out there that is gaining some traction, and for which there are reports of immune system evasion.  It is called the epsilon variant.   The reports of immune system evasion are based on antibody studies, not real life situations and the significance at this time is unclear.  Let’s collectively hope that the story ends similarly to the delta variant and that vaccinated individuals are able to successfully fight off this variant effectively as well.

Shpongle performing their farewell show at Red Rocks.  Saw these folks when randomly searching for something to listen to a few weeks ago.  Here’s hoping they behave like “The Who” and have multiple farewell tours.   

Vaccination Update

Boosters

There have been a lot of questions asked of us this week as to whether booster vaccines are going to be needed.  These questions are largely arising out of the apparent discrepancy between statements and actions by Pfizer with the CDC.   The CDC is not recommending booster vaccines at this time to protect against COVID-19.  Based on current data, I would agree with this statement.  Pfizer has begun conducting studies on booster doses and intends to seek approval for them.  While presented as such in the media, this IS NOT contradictory.  At some point, it may become necessary and recommended to get a booster dose.  It would be irresponsible not to prepare for this possibility.  That means doing the studies NOW to show it is both safe and boosts the immune response.  That way, when and if it is needed, we can simply roll it out there and get the job done quickly.  An ounce of prevention is worth a pound of cure.  Among the brilliant quotes from Ben Franklin (who ironically lost a child to smallpox because he chose not to vaccinate them).

When Will They Start Vaccinating The Youngest?

We have also been asked daily about expectations regarding vaccinating the youngest of our population.  It appears that the earliest this is going to occur is this winter.  The studies are currently ongoing and until the data has been collected, analyzed, and reviewed by the FDA and CDC it is a moot point.

Adolescents and Young Adults

There have been 7 million fully vaccinated adolescents.  If you include young adults (up to 25 years of age), 20 million have been fully vaccinated in this age group.  There have been some very rare side effects (such as myocarditis), but the vaccine is clearly safe and effective in this age group.  While the individual risk of poor outcome in this age group from getting COVID-19 remains low, vaccinating this age band does provide protection both for them and those around them.

Adults

If you haven’t gotten the vaccine yet, you should.  How simple is that?

Some Grateful Dead to close things out today.  New Minglewood Blues from Alpine Valley on this date in 1989.

Perspectives

Now that the pure numbers have been presented, how do we interpret them?  Where are things going?  This my friends depends on who’s eyes you are looking through.

The Vaccinated Individual’s Perspective

Numbers are going up?  OMG.  Wait, what did you say?  Oh, 99% percent of the deaths are in the non-vaccinated?  Phew!  So far then, so safe.  Here’s hoping that no escape variants emerge that force me to take a booster.  Where is the next get together?

The Unvaccinated Individual’s Perspective

Monday: Numbers, shnumbers.  Friggin hoax.  It’s a cold.  I am gonna survive it 99% of the time anyways even if I am wrong.  I love not wearing my mask.  Free again!

Thursday:  I can’t smell my kids poop diaper?  She vaping Ozium?  Eating magic erasers?  What’s with this fever?  My body hurts, lugging this kid around at age 32 is just killing me…..

Saturday:  I feel like death, what should I do to protect my little one?  Anyone want to come help out?

The Child’s Perspective

Yo mom and pops…..can all y’all take your damn pokes already.  Billions of doses given.  And it works!!  Please don’t make me wear that damn mask in school again cause y’all can’t deal with poking yourself.  I have to wear it to protect you from your own ignorance?  Really?

My Perspective

People are collectively begging for an ass kicking.  Based on my view at Target and Stop and Shop, 100% of the population is vaccinated.  Only I know better.  I am grateful the vaccine is darn near perfect in keeping vaccinated folks out of the hospital or from dying.  I am well aware that at any time there is risk, if a virus continues to circulate, for a variant to emerge that can render the current vaccine useless.  I am simply hoping that if folks are committed to not being vaccinated that society has the fortune of them getting COVID-19 as soon as possible so they can join the immune herd.  The hospitals are empty now, plenty of room to handle the situation.  And at this point, unless the virus starts to effect significant numbers of children adversely, let them live their best lives.  They should no longer be held back to protect folks that are not interested in protecting themselves.

Fun fact:  If you are vaccinated against COVID-19, you are more than 25 times more likely to die in a car accident than from COVID-19.

Conclusion

We can distill this down real easy today…..disease burden is picking up nationwide, but only consequentially for those who decline the vaccine.  This is all fine and dandy for now, but now watch our politicians ignore the science and torture us all again.  Get ready for your return to mask wearing in all settings.  Watch them torture the kids in school.  And why?  Because 30% of our population continues to ignore science.  Only in America can you have a surplus of vaccine that nearly guarantees survival from a deadly illness because of suspicion that the entire scientific, medical, and political community is out to get them.  Mind boggling.

Post authored by Jason Halegoua PhD, MD, MBA, FAAP.  Jason is the founder of Peds First Pediatrics in 2009, and has been a practicing general pediatrician since completing residency at Schneider Children’s Hospital in 2004.  In addition to earning his medical degree from the Medical College of Pennsylvania, Jason earned a PhD in Molecular Pathobiology for his work contributing to the understanding of the genetic regulation of immune responses to murine leukemia viruses from Hahnemann University in Philadelphia and an MBA in Finance from Hofstra University.