COVID Convos #34

Springtime, Herds, Hunger Games, Canadian music

What a topsy-turvy-churny world we live in these days! Spring is coming, but we still have a pandemic. It’s been a sunny and warm week, but vaccines are hard to find. It’s disorienting to consider where we’ve been, and confusing to imagine where we are going. But don’t worry, COVID Convos is coming to sort it all out!

Spring is Here

So first off, happy Meteorological Spring! While Astronomical Spring isn’t until March 20th, the dedicated weather nerds count March 1st as the beginning of spring, and the recent week full of sunshine and chirping birds support that. I have nothing against the Equinoxes — really, I think they’re pretty cool — but meteorologists everywhere are right: the real springtime runs from March through May. I hope you got outside and enjoyed this week’s niceness before the (spring) rains returned. More good news: our local coronavirus case numbers are low!

A Healthy Herd

Back at the beginning of the year, I predicted that 2021 would be the year that we achieved Herd Immunity. Whether it be through vaccinations or widespread exposures or both, I still predict that we will get there.

In some parts of the country, the prediction is already starting to come true. Take a look at North and South Dakota, which had a nightmare caseload in November. Some parts of those states had ~25% of their population with a lab-confirmed case, so conceivably the actual exposure numbers were 50%+. Mix in a decent vaccine rollout, and the Dakotas may be approaching the 70% needed for herd immunity.

An important nuance to consider: herd immunity doesn’t magically kick in at a specific number. Even when only 30% of the population has antibodies, that will result in a measurable decrease in COVID’s R0. Fauci is aiming for 70–85% for “full” herd immunity, but every percentage higher is a step in the right direction.

Vaccine Hunger Games

Vaccine tourism, with people flying from Massachusetts to Florida to get a dose. Rich white folks in LA and NYC going to poor black neighborhoods to take advantage of available doses. My healthy 22-year old babysitter getting immunized because she is a “teacher,” sort of. The Providence hospital system immunizing their C-suite, despite none of those people having contact with patients. Scarcity disproportionately impacts the poor, while favoring the rich.

Here in Oregon, hundreds of thousands of eligible senior citizens have been trying to get access to the few thousand doses that are available each day. The average time spent to get an appointment has been reported to be at least 3 hours per patient. Less than 1% of attempts to book an appointment resulted in appointment. What. A. $#;+show! This isn’t a disaster we can blame on Trump, this is our own Oregon problem.

I saw it first hand this week when my wife was trying to get an appointment for the elderly lady who lives next door. It took two days of trying, between hours online and some detective work amongst doctor friends, to find a dose for this eligible and deserving patient.

Fortunately, and better late than never, Oregon is finally moving to a fair reservation system. If you want a vaccine (even if you’re not yet eligible) go now to the Oregon COVID-19 Tool to get your name on the reservation list. Patients will be sorted based on eligibility, and invited to sign up for appointments. If you use this tool please let me know how it goes…I want to hear real-world experiences. Meanwhile, my fingers are crossed that this is a much better system.

Vaccines for the Kids?

“I want a shot!” is something my kids never used to say, but they are ready to be done with this pandemic. Are they motivated to roll up a sleeve because they are such good citizens? Probably not. More likely, they are hoping that vaccination will give them permission to have sleepovers again.

Good news for them: Pfizer, Moderna, and J&J are testing their vaccine in kids ages 12 and up. Johnson and Johnson is going to test their vaccine in all ages including infants; their single-shot vaccine is based on an adenovirus, and this type of vaccine has previously been safe in all age groups. Results are not expected until this summer, and those results will focus more on safety than efficacy. This is because right now the rate of COVID infection in kids is so low that there are not enough patients getting infected to prove a protective benefit.

I am predicting that the vaccine will not only be safe for kids but, that for middle school and up, a single-dose vaccine will be optional but available prior to starting school in the fall.

NYC, A Test of Immunity?

The good news: New York City has about 20–25% immunity thanks to the first few waves of COVID, and this percentage is increasing every week as vaccine rollout improves.

The bad news: NYC also has its very own new COVID strain named B.1.526 which features both spike protein variant E484K, and the S477N mutation that enhances binding to human cells. In other words, this could be a nasty variant that evades immunity and vaccine antibodies.

The test: How bad is this new strain? How good is the protection from acquired immunity? How much immunity do the vaccines convey? We might be about to learn the answers to these questions by watching the Big Apple’s results. Here is a link to the NYC dashboard so you can follow along. Right now there hasn’t been a perceptible spike in cases; fingers crossed that this remains the case.

A Soundtrack for COVID

I heard a new song the other day: “Atlantic” by The Weather Station. It’s nice music, catchy and easy on the ear, and it even features a flute. But what stood out to me is that it’s the first song I’ve heard that’s about this pandemic. The lyrics reveal the singer sitting in the grass, drinking wine, watching a sunset as she gazes out at the ocean. Despite a perfect setting and birds flying overhead, she can’t stay in the moment and keeps “thinking I should get all this dying off my mind; I should really know better than to read the headlines.” Exactly! Reading bad news headlines is an unfortunate way to spend your evening, especially when you could be watching a sunset.

That song really sums up the topsy-turvy-churny mental turmoil I’ve felt this week with the sunshine and buzzing bees outside, but a pandemic still weighing on all of us. Way to go Weather Station for putting that emotion into a song… wait, hold on, here’s an update: apparently this song isn’t about COVID at all, it’s about climate change. Hmm. Oops, I guess Canadians have different worries, probably because their coronavirus mortality has been less than ⅓ of what the US experienced. Nevertheless, it’s the best song to feature a flute so far in 2021, COVID lyrics or not.

Breaking News: Oregon’s Strain

I’m still processing this news because it’s hot off the presses, but it appears that Oregon has spontaneously sprouted a new strain that features the scariest parts of both the British and South African variants. Uh-oh.

Something a Little Lighter

Meanwhile, the New Yorker has published some thoughts around the ethics of COVID vaccination, so go check that out. (disclaimer: it’s in their Humor section) That’s it for today. If you want to get off of this email distribution, just let me know.

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