Coronavirus Tidbits #104 12/16/20

December 16, 2020 /

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Announcements:

First, there is now a Resources Page here for the most commonly asked questions I’m getting.

Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.

News 

Electoral College votes without incident – Joe Biden acknowledged to be President

although a few naysayers remain, and Congress has to confirm.

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Almost 2 billion people depend on health care facilities without basic water services

Worldwide, 1 in 4 health care facilities has no water services, 1 in 3 does not have access to hand hygiene where care is provided, 1 in 10 has no sanitation services*, and 1 in 3 does not segregate waste safely.

https://worldhealthorganization.cmail20.com/t/ViewEmail/d/45B7725D20DAD4032540EF23F30FEDED/6839E639424B8857E89F0E32AAFB68BF

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FDA Vaccine Advisory Committee meets Thursday, Dec 17 to review Moderna’s EUA (Emergency Use Authorization) application

Materials for this meeting will be available at the Vaccines and Related Biological Products Advisory Committee meetings main page. and it will be streamed.

https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-december-17-2020-meeting-announcement

Diagnostics:

still an incredible, negligent lack of rapid, accurate testing. But!

FDA Authorizes Antigen Test as First Over-the-Counter Fully At-Home Diagnostic Test for COVID-19

The Ellume COVID-19 Home Test correctly identified 96% of positive samples and 100% of negative samples in individuals with symptoms. In people without symptoms, the test correctly identified 91% of positive samples and 96% of negative samples.

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-antigen-test-first-over-counter-fully-home-diagnostic

Drugs:

Moderna vaccine data looks great!

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FDA’s analysis details support for Moderna COVID vaccine

the vaccine was effective against severe disease; of 30 people with severe infections, none were in the group that received the vaccine. Like the Pfizer-BioNTech vaccine, the one from Moderna shows protection across a range of groups, including people of color, different ages, and both sexes. And similarly, temporary side effects were common, including fatigue, headaches, muscle aches, and injection-site tenderness.

However, additional data from Moderna suggest the vaccine may protect against asymptomatic infections, a key consideration in a vaccine’s usefulness for preventing the spread of the virus to others.

A reminder that this vaccine, which Moderna will market and profit from, was made from taxpayer funded discoveries, as I wrote about in “The People’s Vaccine”

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Sanofi’s vaccine is in trouble…

Turns out that the formulation had too low a dose of the protein (antigen)…so healthy adults got some immune response, but older people, who usually need higher doses, didn’t get enough.

The good news: “the vaccine prevented damage in the lungs, which is what triggers severe Covid disease in people, and led to rapid clearance of the virus.”

The other problem is that Pfizer’s vaccine (and likely Moderna’s) was just approved.  So review boards would likely believe that a placebo arm would be unethical and not allow it–or if people know they may soon have access to an authorized vaccine, they are is unlikely to enroll in a trial where they might get a placebo.

Sanofi is proposing to the Food and Drug Administration that its Phase 2b trial compare its vaccine to one that is already authorized, not a placebo….but both Pfizer and Moderna’s vaccine have reported an almost 95% efficacy in their Phase 3 trials. That would be hard to match. Would the FDA authorize a slightly less effective vaccine? Given the trouble manufacturing enough to meet the need, I would hope so.

The Sanofi vaccine has the advantage of being able to be kept in standard refrigerators. The vaccine uses the same approach as that of their influenza vaccine.

for more, see https://www.statnews.com/2020/12/11/sanofi-suffers-major-setback-in-development-of-a-covid-19-vaccine/?

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Rich countries cornered the market on early vaccines

The majority of East African citizens will have to wait till 2022 to access the Covid-19 vaccine as the available doses (specifically Biontech-Pfizer and the Moderna) have been pre-purchased by rich countries.

This leaves the region at the mercy of the Gavi vaccine initiative — Covax, co-led by the World Health Organisation.

While there are more than 230 Covid-19 vaccine candidates, only two are being tested in Africa — in Kenya, South Africa and Egypt, limiting options available to African countries.

So far Oxford’s AstraZeneca Covid- 19 vaccine remains the convenient option as it can be stored under the same cold chain storage used for other primary vaccines already in use across the region.

the Covax facility will only provide 20 percent of the vaccines needed.

https://www.theeastafrican.co.ke/tea/news/east-africa/rich-countries-roll-out-vaccines-for-their-people-poor-ea-waits-at-back-of-the-queue-3228072

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Another problem with vaccine acceptance – women are wary

American women, who traditionally make most of the healthcare decisions in their families, are more wary than men of the new, rapidly developed COVID-19 vaccines, according to a Reuters/Ipsos poll, presenting a potential challenge to efforts to immunize the public.

The Dec. 2-8 national opinion survey showed that 35% of women said they were “not very” or “not at all” interested in getting a vaccine, an increase of 9 points from a similar poll conducted in May when vaccines were still being developed.

Also a sharp drop in the number of parents willing to give their children the vaccine – 53% versus 62% in May.

mothers also tend to be the ones who make doctor’s appointments and keep up with immunizations,

https://www.reuters.com/article/health-coronavirus-vaccine-poll/more-women-than-men-in-u-s-nervous-about-fast-rollout-of-covid-vaccine-and-thats-a-problem-reuters-ipsos-poll-idUSKBN28L0F3

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And Blacks and Latinos are wary of the vaccine

https://twitter.com/KizzyPhD/status/1336846460139286529?s=20

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https://twitter.com/flywithkamala/status/1336507336031133697?s=20

More at https://www.complex.com/life/2020/12/fauci-spotlights-dr-kizzmekia-corbett-black-woman-covid-vaccine-development?

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Strategies to promote a national COVID-19 vaccine program

Politicization has dropped the trust in the vaccine from ~70% in mid-summer to ~50% now…so we’ll have to claw our way back to acceptance, without which we won’t have protection of the population.

The recommended strategies are:

  • Make the vaccine free and easily accessible.
  • Make access to valued settings conditional on getting vaccinated.
  • Use public endorsements from trusted leaders to increase uptake.
  • Provide priority access to people who sign up to get vaccinated before vaccines are widely available.
  • Transform individual vaccination decisions into a public act.

https://www.eurekalert.org/pub_releases/2020-12/uops-bst121420.php

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Interesting footnote:

Biden stated that the DoD will have a major role in distributing the Covid-19 vaccines as part of an op-ed in The Atlantic explaining his selection of General Lloyd Austin as Secretary of Defense.

Devices:

Masks

latest recs from Linsey Marr, Virginia Tech air/ventilation expert:

Combining the study’s findings with existing published literature on mask layering, Marr’s team came up with recommendations for fashioning a particularly effective homemade face covering: make it three layers, with a soft, flexible, tightly woven fabric layer up against the mouth; a layer made of material designed to filter particles, like a vacuum bag or MERV 14 filter; and finally, another soft and tightly woven outer layer of fabric. The face covering should fit snugly against the wearer’s face with no gaps that could affect its performance.

https://vtnews.vt.edu/articles/2020/11/eng-marrmasks-1123.html

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Epidemiology/Infection control:

How airflow inside a car may affect COVID-19 transmission risk

“When the windows opposite the occupants are open, you get a flow that enters the car behind the driver, sweeps across the cabin behind the passenger and then goes out the passenger-side front window,” said Kenny Breuer, a professor of engineering at Brown and a senior author of the research. “That pattern helps to reduce cross-contamination between the driver and passenger.”

https://www.sciencedaily.com/releases/2020/12/201205143458.htm

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Mexico warns of deadly fungus Candida auris associated with #Covid19

http://www.plenglish.com/index.php?o=rn&id=62727&SEO=mexico-warns-of-deadly-fungus-associated-with-covid-19

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Household Transmission of SARS-CoV-2A Systematic Review…

Findings  In this meta-analysis of 54 studies with 77 758 participants, the estimated overall household secondary attack rate was 16.6%, higher than observed secondary attack rates for SARS-CoV and Middle East respiratory syndrome coronavirus. Controlling for differences across studies, secondary attack rates were higher in households from symptomatic index cases than asymptomatic index cases, to adult contacts than to child contacts, to spouses than to other family contacts, and in households with 1 contact than households with 3 or more contacts.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2020.31756?

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

https://twitter.com/linseymarr/status/1329512125627330563?s=20

Politics:

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https://twitter.com/MollyJongFast/status/1338244477232799745?s=20

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https://twitter.com/soapachu/status/1337750447596199940?s=20

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ER Doc Cleavon Gilman ‘Fired’ for Tweet, Hopes to Return to Work

“What I don’t get is how I’m in a state where they talk about freedom of ‘I don’t have to wear a mask,’ yet I don’t have the freedom to speak openly about this deadly pandemic. And that’s what this hospital did they … tried to muzzle my voice.”

https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/90187?

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Interesting perspective; worth a read:

Why Democrats Keep Losing Rural Counties Like Mine

https://www.politico.com/news/magazine/2020/12/01/democrats-rural-vote-wisconsin-441458?

Feel good du jour:

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Comic relief:

Perspective/Poem

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Bits of beauty:

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2 Comments

  • Connie Valentine

    December 18, 2020 at 12:41 am

    Judy,
    Thank you again for your tireless effort required to do this.
    I love the hummingbird, the kitten and rabbit, the beautiful gem-like sparkle at the beginning, the humor, the depth, the intensity of the information. It is so important.
    Thank you,
    Connie