Coronavirus, Vaccines, and how I Think About It All - 4/2/21
TLDR (too long didn't read); The Moderna and Pfizer vaccines are safe and good for humanity, our country, our community, and you.
Now, I want to move to who I am and what I believe in. This is hanging on the wall in my house and is what I’m trying to live by writing this article:
Honesty - I'll tell you the truth. I'll tell you how I know it and I'll tell you if I don't know something.
Humanity - I'll frame things in terms of what's good for every human, our county, our area, your family, and you.
Productivity - I want to do something about suffering I see people everyday in my practice going through.
Tenacity - I'm not going to give up just because it's hard.
I feel sad, worried, and a sense of avoidable tragedy for those Americans that don’t get vaccinated for Covid, but I don’t want to sit around and do nothing about it. And let's be super clear; there is something we can do! I care about all of you and the people in our country. And also motivating me is that I don’t want to have it on my conscience that I could have said something or done something to prevent bad things from happening to people I care about.
I also feel it is unfair to our children to continue to spread this virus in our community by having large numbers of people unwilling to vaccinate themselves, knowing that they cannot be vaccinated yet. Last week 50 students at Fieldcrest High School were in quarantine at once and a teacher was telling me how difficult that is when the students aren’t at school. Vaccine trials are currently underway for ages 6 months to 12 years and will likely be approved later this year. But, by and large the majority of children will not be vaccinated for quite some time. Also, while it’s rare, Multi-inflammatory Syndrome in children is happening. In addition, while rare, 226 people under the age of 18 in the US have died of COVID.
The long term effects of infection from this virus are unknown and may not be known for decades. Hopefully, it’s not an issue, especially considering how many people have been infected. But we do know that other viral illnesses are tricky and have delayed effects. For example, an infection with Chickenpox as a child can present as shingles multiple decades later! And we all know that infection with HPV can cause cancer decades later. This isn’t a guilt trip, viruses are tricky. This is bigger than any one of our fears.
Ultimately, the decision is yours and I will not make you feel guilty if you don’t want a vaccine, but I also want to express my thoughts and feelings and know that I did everything I could do. I believe you are safer and our community is safer if we are all vaccinated.
One of my main concerns is something now being termed “Long Covid.” It is generally underappreciated because the cases do not show up in the death numbers, but these people are having long lasting effects. The main symptoms are chronic fatigue, inability to sleep, and “brain fog.” There are patients that have now had Long Covid for a year and they still have these lingering symptoms. It’s not known what the mechanism is that causes Long Covid and we don’t know a proven treatment for it. Anecdotally, meaning I don't have great data yet, Long Covid seems to be happening more in female vs male patients. Long Covid is happening more in patients that were NOT hospitalized... meaning initially, they had milder symptoms. Long Covid also seems to be happening more in Caucasians. Again, I don’t know why or even what the exact numbers are. Here is some more information about Long Covid. He starts talking about it at minute 25:30. https://youtu.be/FHzo4ujgaPA . Here is a link to the article that he references https://www.nature.com/articles/s41591-021-01283-z .
One especially emblematic story is from a patient of ours. She is a nurse who got covid in December 2020 from her husband, not from the hospital. She is 39 with no preexisting conditions. She had a relatively mild case but now over 3 months later continues to suffer. In her words “I was always very smart and never needed reminders or lists but now (March 11, 2021), I need reminders to pay my bills and use checklists at the office, so I don’t forget anything. I have a brain fog that makes it difficult to recall facts and I’m worried that the hospital may not be the best place for me if this continues, mentally. I haven’t made any mistakes yet but I am worried.”
As many of you may know, cases are on the rise again in our area.
Woodford (weekly case rate per 100k)
Marshall (weekly case rate per 100k)
So we will likely start seeing increases in cases of patients and in our schools. There are other troubling trends happening around the country and the world.
IN THE US
Michigan Data (daily case rate per 100k)
The most recent data from Michigan shows that the younger age groups are primarily the ones getting infected.
The data from Michigan also shows that the B.117 variant is prevalent.
Februrary 22nd was the last day we saw average cases decline and we have seen a plateau for the last 5 weeks.
Also, herd immunity from natural infection seems to be a mirage. In Manaus, Brazil - by October 2020, 76% of the population had been infected and had antibodies. You would think that would drastically reduce the ability of the virus to spread, right? Well the P1 variant present in Brazil had no trouble spreading again and hospitalizing even more people the second time around in January of 2021. https://www.thelancet.com/article/S0140-6736(21)00183-5/fulltext
559 million doses have been administered worldwide. In the U.S. 146 million doses have been given. Currently, the daily average is 2.76 million doses. There has been no incidence of any serious complications or death related to the vaccines. The rollout was bumpy from a logistical standpoint, but the safety record has been amazing. There haven’t even been safety concerns that may have been picked up at a rate of 1:100,000 or something that wouldn’t have been seen in the trials of ~35,000 people.
Also, in the latest CDC issue of the MMWR report a study of 3950 healthcare workers showed a 90% reduction of positive tests in vaccinated vs unvaccinated Healthcare workers. They were tested for SARS-CoV2 weekly via PCR nasal swabs whether they had symptoms or not. They also found a 80% reduction in positive tests for those who had only received 1 vaccine dose. This was for both the Pfizer and Moderna vaccines. It stands to reason that you cannot transmit the virus if you are PCR negative but I don’t know of any definitive proof but signs are pointing strongly to a large reduction in transmission from the vaccines. https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm?s_cid=mm7013e3_w
Israel is leading the world with 56.1% of the population vaccinated. The US has about 22% fully vaccinated. The current average daily case rate per 100,000 in Israel is 6 and falling vs the US at 19 and a plateau.
Now some good news, 70% of American adults now say will get the vaccine, up from 62% in February. 36% have gotten at least one shot of the vaccine already and 34% will get it when one becomes available to them.
In summation, I told my office that I will not require a COVID vaccine and have no plans to do so in the future. I won’t judge you, treat you differently, and I will love you anyway, if you decide not to. I do feel like there are immense benefits to humanity, yourself, your family, our children, and our community if we can get to herd immunity and the only likely path is through mass vaccination. All this benefit comes with an extraordinary small risk and that has not materialized in any evidence to date for the Pfizer and Moderna vaccines approved in the US. Be safe and take care.