COVID-19 Update: Wednesday, February 3, 2021

Pharmacies, Sputnik V, more mutations, adverse events, and other vaccine info, and what to do if you get COVID.

1. COVID vaccines are on their way to retail pharmacies around the country to help expand distribution. The initial shipment is expected on 2/11 and should be for about 1 million doses and 6,500 pharmacies. The final goal is to have vaccines in 40k pharmacies.

2. The Russian vaccine, Sputnik V, appears to be 92% effective which is quite impressive. 12 countries have already made moves to acquire it.

3. When following mutations of the virus we often use the acronyms VUI and VOC. VUI's stands for "variant under investigation" VOC stands for "variant of concern." Another mutation has occurred in the UK (B.1.1.7), SA (B.1.351), and Brazilian (P.1) variants (VUI) that has scientists concerned (VOC). The VOC seen within all three VUI's (UK, SA, and Brazil) appears to make the virus more resistant to the vaccines and therapies. This is developing and quickly shifting science so stayed tuned for more. The good news is that these (thus far) seem to apply to the mRna vaccines, we don't know about the others yet although J&J conducted their study in part in South Africa so we do know that the J&J vaccine is still around 50% effective against it. The J&J vaccine is also a single dose so I am eager to read a more detailed report on their clinical trial results. That should come out this month. For those getting the Pfizer or Moderna vaccines, a booster shot may be available in the future to provide protection against some of these new variants.

4. Some people are persistently testing positive for COVID months after they recover. In a research study to determine if they were still contagious, the results indicate they are not despite still having what appears to be active virus at detectable levels. You can read more about that here: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(21)00023-2/fulltext In related news, some people who lose their sense of smell during COVID may experience phantom smells upon recovery. Unfortunately, these are not roses and chocolate and fresh-baked bread sort of smells but are stinky smells. So if that happens to you - it is "normal" and people are trying to figure out why it is happening and how to stop it. For those interested in a primer on the science behind what we know I found this one - it strikes a nice balance for those who are scientifically minded versus those who are not. https://covidactnow.org/covid-explained/the-path-of-the-virus?utm_medium=email&utm_campaign=Daily%20Download%20%2002%20February&utm_content=Daily%20Download%20%2002%20February+CID_03592ca431885b912a13dc23b7016798&utm_source=Email%20marketing%20software&utm_term=our%20explainer And here is one from NPR that uses leggos - https://www.npr.org/sections/goatsandsoda/2021/02/02/961668700/whats-going-on-with-all-these-coronavirus-variants-an-illustrated-guide

5. In a preprint study to be published in the Lancet (if accepted), researchers found that a single dose of the AstraZeneca vaccine was 76% effective after one dose and the protection lasted up to 3 months. This finding will help with the question about delaying second doses in order to get more people vaccinated more quickly. The study also suggests that after receiving the second dose (up to 12 weeks later) efficacy went up to 82% (rounded). You can read the study here: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3777268 As a reminder, currently the vaccines are designed to prevent symptomatic COVID, serious illness and/or death. Meaning, the best-case scenario, you still get COVID but will be asymptomatic. Or, you may get it and become ill but not severely ill. Remember, vaccines don't work in 100% of people 100% of the time. So some people may still get sick. That is true of nearly all vaccines. It is also true that you may still get COVID and just not know it. That isn't unexpected. But it does mean, until enough people are vaccinated, you still need to use precautions to protect those around you.

6. As of 1/22/21 there have been over 9k adverse events reported in relation to the two currently available vaccines in the US. 9k out of over 19 million doses administered. It is important to note that these are reported events but they have not been investigated or confirmed as vaccine-related. (so some may not be). 80% of all adverse events were associated with Pfizer - but keep in mind some of that may be explained by the fact that the Pfizer vaccine has been available longer. 76% of all reports occurred in females with the majority occurring in females ages 30-39. But again, that is not completely unexpected as women represent the majority of healthcare workers. There are 285 deaths reported. Again, note these are under investigation and may not be directly associated with the vaccine. This number represents anyone who died within 2 weeks of receiving the vaccine. If all 285 deaths are attributed to the vaccines it will represent a vaccine-related fatality rate of 0.0014914%.

7. Someone asked me a great question so I wanted to take time to answer it. What do you do if you get COVID. Great question. First, if you think you may have COVID, get tested. I have heard lots of people say they don't need to be tested because it won't matter anyway. But it does for so many reasons - here are a couple. a) it helps us have accurate case counts which impact our understanding of herd immunity, fatality rates, trends, and so many other things. People ask for this data regularly - as they should - so having you counted in those numbers helps. b)should you become seriously ill it saves time in treatment because you have a confirmed case. c)should you be in a situation where you have to be quarantined due to close contact to someone else with COVID, you will have proof that you already had it and therefore won't have to quarantine. These are just a few reasons. Ideally, you will test on day 5 of symptoms. This gives you the best chance at a true result (positive if you are positive and negative if you are negative). Next, you need to work with public health or your employer or school to identify close contacts so they can follow local policy. You need to stay home. Truly and really stay home. No running out to the store, no quick trips to the xyz. Stay home. If you live with others, ideally you will isolate yourself from them. Wear a mask around your family members. Use a bathroom no one else uses. It should be cleaned regularly. Realistically I know this is hard and maybe not possible or reasonable. Drink plenty of fluids - particularly if you have diarrhea or vomiting. Stay hydrated. Rest. Some people may not feel very sick. Excellent. Others will feel much sicker. Rest according to how you feel. Do not push yourself. Call your doctor if you feel worse.

8. Additional research has come out suggesting potentially long-term implications for central nervous system disorders for those who get COVID.

9. Some folks in China have been arrested for making and selling fake vaccines. So just know that is happening. Don't get your vaccine from the back of a van from a guy wearing velvet. Not that there's anything wrong with velvet.

And now I have to stop or we will never get on with our days. But here is a fun video of some groundhogs eating from a miniature picnic table to brighten your day. https://youtu.be/wE_dvTtnUoc

FINAL THOUGHTS: I get asked pretty regularly if I am going to get the vaccine. The answer is yes, I am. But I just want to say that it is totally ok to be hesitant. Hesitate. Ask questions. And only get the vaccine if and when you are ready. This is a personal decision only you can make and every situation is different. You must make the decision you can live with. My hope is that during that process you would seek out good information, that you would not spread false information, and that you would respect everyone's right to decide for themselves without undue influence. We have been through so much already - we really don't need to argue with each other over this. Make your choice and let others do the same.