COVID-19 Update: Friday, December 11th

Numbers, Vaccines, and How it works.

I want to share some numbers with you (because I do that on Fridays) and then I want to talk a little more about what we know about the vaccine, how the approval process works, and clarify a few points on immunity.

1. Numbers - We hit 16 million cases yesterday which means we added another million cases in only 4 days. That is much too fast. We have added 2 million cases in the last 9 days. We will pass 300k total US deaths today unless something unforeseen happens. Keep in mind these numbers are slightly dependent on which tracking system you are using and which time zone that the tracking system uses. I have attached my Friday Charts so you can see visually how fast we are moving. If this pace continues we could hit another million cases by EOD Sunday. If we hit it Sunday we are moving faster if Monday we are holding steady and if Tuesday or later we are slowing down. You can monitor that here if you are interested: https://www.worldometers.info/coronavirus/

2. The vaccine - I wanted to take some time to explain how this process works, what the results are, and what to expect from here. The FDA calls together independent experts (scientists, doctors, researchers, virologists, etc.) and they review the vaccine data provided by Pfizer and then vote. That happened yesterday with most voting in favor, 4 voting against, and 1 abstaining.

My interest is in the 4 who said no - because I want to know what their concerns were. Not a lot of information has come out about that but at least 2 of the 4 have publicly commented that their concerns were the age range of the vote. The vote was to approve for those 16 and up, and they felt there was not sufficient evidence in those under 18, which is a viable concern. Both of them also said they felt very confident in the vaccine for those over 18. From here, the FDA will vote. (the first vote is the independent panel of experts; they are not FDA employees but an advisory panel). Once the FDA votes, then it goes to the CDC who will also review all the data and vote. If the CDC does not vote in favor, the vaccine will not go out. If they do, then it will begin shipping out and people could start being vaccinated by the end of the weekend. The Moderna vaccine will begin this same process of review on the 17th.

We need somewhere around 60-70% of Americans to be vaccinated in order to achieve herd immunity. Herd immunity, you may recall, is the result of enough people being vaccinated that we essentially block the virus from being able to find enough vulnerable people to infect. The 60-70% may fluctuate, it varies by disease and vaccine and involves a calculation that will be refined as we learn more, so expect it to fluctuate, but that is the general understanding we have right now. It is going to take time to achieve this. Manufacturing limitations, distribution limitations, vaccine hesitancy etc. will all play into how long it takes to achieve herd immunity. These are all to be expected, patience will be key.

As a reminder, the current recommendations are that the following people not be vaccinated with the Pfizer vaccine until further research is conducted (please know that the Pfizer study continues even if they get EUA approval). Pregnant women, those who are severely immunocompromised, those with a history of severe allergies (those requiring they carry an EpiPen) and children under 16.

3. I would like to offer just a little bit of information about the immunogenicity response some people are experiencing. The way vaccines work, they take some form of the virus (dead virus, weakened version of the live virus, a “slice” of the virus, etc.) and they introduce that to your immune system in a way that your immune system launches an attack on the virus. The fight isn’t fair, it is a guaranteed win for your immune system. Then, when/if you encounter the full, live virus in real life, your body is ready and can defeat it easily. Think of it as training camp – you get to have a practice run in which you are guaranteed to win.

When you get a vaccine, your body launches an immune response – that is precisely what should happen. In some people, this happens without you even realizing it. Some people may feel tired or achy, perhaps even a little run down for a day or two. This is because your body is busy fighting off the “enemy” and that requires a coordinated effort, energy, and white cell production. And for a few, you may actually feel sick with a fever, aches, chills, etc. Why do some people experience none of this and some do? We don’t know. But this is normal and it is your immune system doing its job – it is NOT a reaction to the vaccine but is your body launching an immune response to the germ. With the Pfizer vaccine, anywhere from 2-15% of people are feeling their immune system kick into action after getting the second shot in the series. This includes fever, aches, fatigue, and chills. These can be quite intense with reported fevers up to 104 degrees. This can be unnerving if you aren’t expecting it and you may feel pretty bad for a minute, so if you get the vaccine, just expect it. The immune response should only last for 24-48 hours. There is a difference between immunogenicity and an adverse reaction. The two people in the UK who had an allergic reaction and needed medical intervention would be considered an adverse reaction.

4. Men are 39% more likely to die from COVID than women are. This trend has been seen globally and despite people attributing it to men taking longer to seek care, the research suggests that is not the case, it is instead related to immune system differences, specifically, “Women produce more type I interferon proteins, which limit the “cytokine storm” immune response. Also, the “female” oestradiol hormone boosts the response of infection-fighting T cells and antibodies—while testosterone suppresses the immune system.

5. I know I have said this before, but I need to say it again because I continue to hear misinformation associated with it. Without intervention, the virus is not going to just “fizzle out” and go away. That is not how viruses work. That does not and has not happened. People try to point to other outbreaks and pandemics and say that they just went away but that is not true. A virus’s entire purpose is to find a host, invade the host, and replicate. It will continue to do that until it is prevented from doing so. Something has to happen to stop the spread.

FINAL THOUGHTS: I hope that you are planning a relaxing weekend full of all things not COVID. Personally, I plan to join Bob Ross and paint some happy little trees. Like most of you, I am over this whole thing. I am ready for normal. I am weary from the incredible sense of loss and the frustration of misinformation. You have been strong, you have held your tongue, you have spread truth and light and love and it is completely understandable if you too are tired and ready to quit. Please hold on a little longer. Take a long shower, go for a hike, bake cookies, play golf, soak in the tub, craft something, write, hammer things, watch Hallmark movies, go for a drive, do something, anything that you find relaxing. Ignore the news. Ignore the virus and tend to your mental health. I will see you Monday.