FEBRUARY BLOG

COVID UPDATE

New Variants of the Coronavirus.  The virus that causes COVID-19 has changed -- once again -- in ways that make it more contagious.  All viruses mutate over time, some more than others. Mutations are errors a virus makes when it copies itself, but sometimes a mutation makes a competitive advantage that allows it to outperform the viruses around it.

The U.K. new “super strain” of the virus is driving an alarming surge of COVID cases in Great Britain.  The U.K. strain had previously been detected in six U.S. states, according to the CDC:  Colorado, California, Georgia, New York, Florida and Pennsylvania.  As of 24 January, 2021, the virus has been detected in approximately 23 states.  Adam Kucharski, PhD, Associate Professor at the London School of Hygiene and Tropical Medicine says the math shows the infectious strain will be more deadly.  30 January, 2021, Maryland became the second state to report a case of the new coronavirus variant that was first found in South Africa. 

The U.K. variant experts have warned is approximately 70% more infectious.  This strain was detected in southeastern England in September 2020 and seems to affect the coronavirus’s spike proteins, which cover the outer coating of the SARS-CoV-2 coronavirus giving it the characteristic spiny appearance!  Data also shows that kids are being infected by old strains, as well as the new one.  The more people who are infected, the more chances there are for a mutation to occur.

Matt Hancock, Health Secretary indicated “a second strain has been found in South Africa, which is more transmissible than other variants and could be on its way to the U.S.  The new South African strain, 501Y.V2, involves multiple mutations inside the coronavirus at the same time.  John Bell, Medicine Professor at Oxford University said his gut feeling was “Pfizer’s and Moderna’s vaccines would still be effective against the U.K. strain, but less certain about the one identified in South Africa.   This is forcing Moderna and Pfizer to reformulate their COVID-19 vaccines and create "booster" shots, just to make sure the vaccines maintain their efficacies.  Some scientists argue it’s too early to call the South African strain more deadly than the British variant or vice versa.

The U.K. and South African super strains have the same mutation on their spike protein, called N501Y.  Each strain developed the mutation independently. The virus is evolving in ways that make it better at infecting humans.  Florida has the largest number of cases from the virus variants, 125 as of 30 January, according to Washington Post data, followed closely by California with 113 cases. 

The Brazilian variant, also known as B.1.1.248 lineage, is a new variant isolate of SARS-CoV-2. The variant first emerged in early December in Manaus, Brazil and by mid-January had already caused a massive resurgence in cases across the city of 2 million people.

The concern with P.1 is twofold:  Scientists don't understand why the variant spread so explosively in Brazil and the variant carries a particularly dangerous set of mutations.  P.1 carries a cluster of mutations along the surface of the virus where antibodies, especially the potent antibodies thrive.  Penny Moore, National Institute for Communicable Diseases in South Africa and the University of KwaZulu-Natal, “When we see a whole lot of mutations in those surfaces it raises the possibility that mutations might be conferring immune escape."   This means the mutations are helping the virus evade antibodies or escape recognition by providing the virus a type of invisibility cloak.

The new strain seems to affect the coronavirus’s spike proteins, which cover the outer coating of the SARS-CoV-2 coronavirus and give it its characteristic spiny appearance.  Data also shows that kids are being infected by old strains, as well as the new one.  The more people who are infected, the more chances there are for a mutations to occur.  Limiting the spread of the virus through maintaining COVID-19 safeguards - mask wearing, physical distancing and practicing hand hygiene - give the virus fewer chances to change.

Some symptoms of the new variant are the same: 

• loss of smell and taste
• persistent cough
• fever 

The WHO lists the less common symptoms as:

• aches and pains
• sore throat
• diarrhea
• Conjunctivitis or inflammation of the mucous membrane that lines the exposed portion of the eyeball and inner surface of the eyelids.
• headache
• a rash on skin, or discoloration of fingers or toes

Serious but rare signs:

• shortness of breath or difficulty breathing,
• chest pains or pressure,
• loss of speech or movement

The White House said it was unlocking a vaccine reserve — but it was reportedly already empty.  Both vaccines require two doses to be fully effective.  During the initial distribution of first doses, the Trump administration held back matching second doses to make sure recipients would be fully protected against COVID-19.  The government said it had been stockpiling more than 50% of the vaccine inventory, saving enough second doses to ensure that everyone who had gotten one shot would be able to get their second booster on time.  A demand for more doses was indicated by the states and Health and Human Services Secretary Alex Azar announced the department would begin distributing the reserves.

HHS spokesperson Michael Pratt said, Operation Warp Speed had "always intended to transition from holding second doses in reserve as manufacturing stabilizes and they gained the ability for a consistent flow of vaccines!"   He indicated states had only ordered 75% of the vaccines available to them. 

Federal officials promised to stop stockpiling second doses of COVID-19 vaccines from Pfizer and Moderna and instead use them to get more people their first shots.  This prompted states to open up vaccine distribution on a wider scale to the public. 

There are no extra COVID-19 vaccines doses left to send to states, despite Trump's health officials promising to release more.  Officials learned the Trump administration had stopped stockpiling second dose vaccines weeks ago - the first and second doses were instead taken off the manufacturing line.  That meant a stockpile didn't exist!  That grab-and-go strategy - of shipping out vaccine doses just as quickly as they were being manufactured - began in December for the Pfizer vaccine.  America's vaccine cupboards are bare!  The U.S. had already reached its maximum distribution capacity. 

Nearly 30 million vaccines distributed, but fewer than 10 million have gone in arms!  Thursday, January 14th, 2020, Operation Warp Speed indicated nearly 30 million vaccine doses have been distributed to states, but shots in boxes do not equate to vaccinations in arms!  According to the Centers for Disease Control and Prevention, fewer than 10 million have received their shots since vaccinations began in mid-December.

"It's a crisis," Dr. Peter Hotez, Professor at Baylor College of Medicine told the Insider.  "….given how much this virus is accelerating and causing deaths at the rate of almost 4,000 people a day, we need to vaccinate at the rate of 1 million to 2 million per day, every day from now until the end of August!  We're not even close to that!"  As states speed up the rollout of vaccines by prioritizing people 65 and older, some, including essential workers, are getting pushed back in the queue, according to experts, union officials and workers.

The “one dose” Johnson & Johnson’s COVID-19 Vaccine is 66% effective overall and above 50% on new emerging variants.  The vaccine had an effectiveness of 85% against severe disease in all regions studied 28 days after vaccination.  Against severe disease the effectiveness improved over time with no severe cases seen after 49 days in those vaccinated.  Lastly, the vaccine offered complete protection against hospitalization and death from COVID-19 in all regions studied.

The U.S. has more than 26.1 million confirmed coronavirus cases and more than 441,319 deaths, according to Johns Hopkins University data, almost double the total of the next most severely hit nation, Brazil.  Approximately 20,000 people are dying per week.  Since March 1, approximately four Americans died every five minutes from COVID-19. With that said you the mass vaccination site at Dodger Stadium, one of the largest in the nation, was shuttered briefly Saturday because of maskless, anti-vaccine demonstrators.

Study: Airborne virus can spread 6 feet within seconds through talking.  Infectious airborne coronavirus particles can spread further than six feet within seconds in poorly-ventilated spaces, according to a new study Wednesday, providing further evidence that ventilation and face masks are key to preventing the spread of COVID-19.

Researchers also found that someone infected with COVID-19 released more particles through 30 seconds of speaking than through a short cough, and those particles could linger in the air and remain infectious for an hour in small, poorly-ventilated spaces.

Covid-19 Vaccine Myths.   
According to Catherine Pearson, HuffPost, there are 8 COVID-19 vaccine myths people need to stop believing.  Millions of Americans have received at least one dose of the Pfizer/BioNTech or Moderna vaccines, both requiring two doses.  Public health experts are working hard to improve distribution across the U.S.  A major roadblock has been vaccine hesitancy and distrust.  Polls suggest that between 50% - 70% of Americans plan to get fully vaccinated against COVID-19, with many Americans still on the fence.

• Myth #1 - COVID-19 vaccines were ‘rushed,’ so they could still be unsafe.  The speed of the vaccines’ creation was unprecedented, but “these vaccines were not ‘rushed’ through development,” said Linda Yancey, an infectious disease expert at Memorial Hermann Health System in Texas.  

Drug manufacturers and the government removed many of the bureaucratic inefficiencies that typically slow the process.  Drug manufacturers were also able to “put all scientists on this one task around the clock,” Yancey added.  You cannot rush the safety trials or the efficacy trials.  Federal agencies, the Centers for Disease Control and Prevention and the Food and Drug Administration, are continuing to monitor COVID-19 vaccine safety in real time as the vaccines are distributed as an added layer of protection.

• Myth #2 - You can get COVID-19 from the vaccine.  Neither the Pfizer/BioNTech or the Moderna vaccines approved for use in the U.S. contain the live virus causing COVID-19.  Many feel unwell after getting vaccinated for the flu, believing they have the virus itself.  But the flu vaccine is made from inactivated or “dead” viruses.

It’s common to develop symptoms after getting vaccinated against COVID-19.  “You’re going to have a nice brisk immune response,” said Yancey.  You may run a fever or feel achy, meaning “you’re getting a good immune uptake and high level of protection.”

• Myth #3 - The vaccines can change your DNA.  The approved coronavirus vaccines use messenger RNA or mRNA.  This technology teaches the body’s cells to make a harmless piece of the “spike protein” found on the surface of the SARS-CoV-2 virus. That triggers an immune response that produces antibodies, protecting against COVID-19 infection.

But mRNA vaccines don’t interact with a person’s DNA.  There are reasons why this can’t happen.  “DNA is protected by a membrane that prevents things from passing through easily,” said Nicole Lovine, Chief Epidemiology Officer at University of Florida Health, Shand’s Hospital.  mRNA goes into the outer part of the cell or the cytoplasm.  It doesn’t enter the nucleus nor does it stick around in our cells for very long. 

• Myth #4 - The COVID-19 vaccines cause infertility.  The American College of Obstetricians and Gynecologists recommends women pregnant or breastfeeding should get the COVID-19 vaccine, although there have not been trials done specifically in that population.

The same goes for women who are considering a pregnancy.  Experts stress there is no evidence getting vaccinated causes infertility.  “One the thing that isn’t being talked about is the potential benefit to fetuses and babies,” said Linda Eckert, an Obstetrician-gynecologist and Infectious Disease expert with UW Medicine in Washington.  “There are antibodies that are anticipated to cross through the cord blood, to the baby and offer some protection.  It should also pass through breast milk and offer protection.”

Eckert added that the lack of trials on pregnant women and COVID-19 vaccination is simply because such trials have long excluded expectant women.

• Myth #5 - You don’t have to get vaccinated if you’ve already had COVID-19.  The CDC says that anyone who has had COVID-19 and recovered should be offered the vaccine, although reinfection is unlikely in the first 90 days.   There are still questions about how long natural immunity lasts, but evidence shows the vaccines are prompting a significant immune response.

• Myth #6 - Once you’ve been vaccinated, you can no longer spread the virus.  Both COVID-19 vaccines take time to be fully effective, because they require two doses spaced fairly far apart:  21 days for the Pfizer vaccine and 28 days for Moderna’s.  Full immunity isn’t immediate after the second booster shot.  For preventing symptomatic efficacy, trials measured:
• the Pfizer vaccine, seven days after the second dose and
• the Moderna vaccine, 14 days after the second dose. 

It’s still not clear if the vaccines prevent the spread of the virus to others.  Currently data shows the vaccines are effective at preventing the person who received both doses from developing serious symptoms.  This means it’s possible a fully vaccinated person may be exposed to the coronavirus, become infected without outward symptoms, yet pass the virus to others.  It is crucial public health measures such as mask-wearing, hand-washing and social distancing, remain in place.

• Myth #7 - Severe reactions to the COVID-19 vaccines are common.  The percentage of individuals who have had severe reactions to the COVID-19 vaccination is low.  Late December, the CDC said of the more than 1.8 million doses of the Pfizer vaccine distributed, there were approximately 21 cases of anaphylaxis, a life-threatening immune response, or less than a 1-in-a-million chance,” Yancey said.  Mild allergic responses are possible within four hours of getting the shot says the CDC.  Anyone who has allergic responses to other vaccines should consult their personal physician for the COVID-19 vaccination.  It is also stated that everyone, regardless of their health background, should be monitored by their physician for at least 15 minutes after receiving the vaccine.

• Myth #8 - You should wait until you can choose the exact type of vaccine you’d like.

It’s a myth there is any significant difference between the approved vaccines at this point.   They seem to behave the same. 

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus.  Check the Centers for Disease Control and Prevention for the most updated recommendations.

Stay safe.  Mask.  Social distance.  Frequent hand washing.  Avoid crowds.

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

• “8 COVID-19 Vaccine Myths People Need To Stop Believing,” Catherine Pearson, ·HuffPost, Thu, January 14, 2021, 8:50 AM
• “The White House said it was unlocking a vaccine reserve — but it was reportedly already empty,” Kathryn Krawczyk, Washington Post, Fri, January 15, 2021, 9:00 AM
• “There are no extra COVID-19 vaccines doses left to send to states, despite Trump's health officials promising to release more 3 days ago,” Hilary Brueck, Fri, January 15, 2021, 10:18 AM
• https://coronavirus.jhu.edu/map.html
• https://www.worldometers.info/coronavirus/
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• https://www.yahoo.com/news/white-house-said-unlocking-vaccine-170030454.html
• https://www.yahoo.com/news/no-extra-covid-19-vaccines-181841660.html
• https://www.yahoo.com/news/coronavirus-updates-later-covid-19-090003638.html
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know
• https://www.webmd.com/lung/news/20210107/new-covid-super-strains-could-disrupt-life-again
• https://www.thesun.co.uk/news/13482268/new-coronavirus-strain-symptoms-explained-cough-headache/
• https://www.washingtonpost.com/nation/2021/01/31/covid-coronavirus-updates/
• https://www.npr.org/sections/goatsandsoda/2021/01/27/961108577/why-scientists-are-very-worried-about-the-variant-from-brazil
• https://www.healthline.com/health-news/johnson-johnsons-covid-19-vaccine-is-72-effective-overall-over-50-on-emerging-variants