Coronavirus Tidbits #105 12/20/20

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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 

Racial disparities in O2 monitoring

More thorough explanation of pervasiveness of racial bias–even in oximeters–at:

bostonreview.net/science-nature-race/amy-moran-thomas-how-popular-medical-device-encodes-racial-bias

Here is the medical journal article:

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Mutations

A new mutation appeared in southern England. It does not appear more deadly or resistant to vaccines, but has been spreading more rapidly.

https://www.washingtonpost.com/world/europe/coronavirus-mutation-britain-lockdown/2020/12/19/fd010eea-4206-11eb-b58b-1623f6267960_story.html?

While the talk of mutations is somewhat disturbing, thoughts are currently that a) the vaccines are very effective but might have to have minor changes =>

b) so may be like the flu vaccine, which needs a slight change in formulation each year

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Fiasco with Pfizer vaccine distribution

states told they would receive between 25%-40% fewer vaccine doses than originally projected. . . and Trump blamed Pfizer for not shipping the vaccine…and Pfizer said they were awaiting orders from the Feds.

raising questions of a) was Trump retaliating against Governors who had crossed him? b) Is Jared diverting doses to their cronies?

What happened to the Pfizer vaccine that was supposed to be shipped? 

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Now General Gus Perna, who runs logistics for Operation Warp Speed, says he made a forecasting error. This follows “labeling confusion that caused hospital pharmacists at several health systems to throw away one in every six doses of the first vaccines distributed.”

https://www.statnews.com/2020/12/19/operation-warp-speed-leader-takes-sole-responsibility-for-covid-19-vaccine-distribution-confusion/

Diagnostics:

Ellume–1st at-home diagnostic 

still an incredible, negligent lack of testing.

Ellume diagnostic correctly identified 96 percent of positive samples and all negative samples in patients displaying symptoms of COVID-19. Results dropped slightly in those without symptoms, to 91 percent for positive samples and 96 percent for negative samples.

https://homelandprepnews.com/stories/58980-fda-authorizes-ellume-test-as-first-over-the-counter-at-home-covid-19-diagnostic/

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Disparities mounting in testing:

FDA issued an EUA for the first over-the-counter, at-home, rapid diagnostic test for COVID-19. The Ellume COVID-19 Home Test, authorized for individuals 2 years old and older, with or without symptoms, detects proteins of the SARS-CoV-2 virus from a nasal swab sample. It can be used completely at home without a prescription and requires the use of a compatible smartphone and a downloadable app.

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-december-16-2020

This will again leave poor and rural communities in the dust.

Drugs:

Moderna vax receives EUA (Emergency Use Authorization) as expected, by FDA

Data looks excellent re efficacy and suggests 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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Pfizer’s vaccine

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“However, since the vials are preservative free, it is critical to note that any further remaining product that does not constitute a full dose should not be pooled from multiple vials to create one,” the FDA said in a statement.

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Pfizer’s temperature sensors fiasco. What’s an extra $25 million when people are hungry and homeless?

Pfizer “planned to disconnect temperature-monitoring sensors on the containers once they were delivered to health care providers — though many of the providers needed to use the boxes to store the vials for up to 30 days. Without the monitoring systems, providers would have no way of knowing if the vials had thawed prematurely, rendering the vaccine unusable.

In the end, the U.S. government’s Operation Warp Speed scrambled to address the problem, signing a $25 million deal in mid-November with Controlant Global, an Icelandic company that created the proprietary temperature-monitoring platform for all Pfizer’s shipping containers. Under this agreement, Pfizer will discontinue its temperature monitoring once the boxes arrive at their destination, and the federal government will simultaneously turn the system back on.”

https://www.statnews.com/2020/12/17/pfizer-decision-to-turn-off-temperature-sensors-forced-scramble-to-ensure-covid19-vaccines-kept-cold/

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Major differences between Pfizer and Moderna vaccines:

So far, efficacy and side effects are ~same.

“Moderna vaccine will be far easier to use than Pfizer’s. For starters, Moderna’s must be shipped at -4 Fahrenheit; Pfizer’s must be shipped and stored at -94 Fahrenheit. The former is the temperature of a regular refrigerator freezer; the latter requires special ultra-cold freezers that need to be topped up with dry ice every five days. Doctors’ offices do not have ultracold freezers; neighborhood pharmacies don’t either.

After thawing, a vial of the Pfizer vaccine must be used within five days; Moderna’s is stable at fridge temperature for 30 days and at room temperature for 12 hours.

Pfizer vaccine. The minimum amount of vaccine a location can order is 975 doses. A large teaching hospital might need several of those. But there are plenty of places across the country that don’t need 975 doses to vaccinate the people currently eligible for vaccination — health workers and nursing home residents. This is the vaccine that needs to be kept at -94 F. The minimum order size will limit the locations in which this vaccine can be used.

The Moderna vaccine’s minimum order is 100 doses, a much more manageable number.

The Pfizer vaccine is shipped in five-dose vials; Moderna’s vaccine is shipped in 10-dose vials.

https://www.statnews.com/2020/12/19/a-side-by-side-comparison-of-the-pfizer-biontech-and-moderna-vaccines/?

 

Devices:

see Diagnostics — Ellume test

Epidemiology/Infection control:

Infuriating, self-centered people

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Disaster waiting to unfold: A wild mink has Covid-19

“It started in nature. A coronavirus that originated in bats has wound up in humans, causing the Covid-19 pandemic.

And it can go back to nature.

The SARS-CoV-2 virus can jump again, from humans, back into animals, back into wildlife, where it can wait, mutate, and change. Perhaps, years from now, it can infect people again.

But now a wild mink in Utah tested positive for the coronavirus. A genetic analysis of the virus suggested the wild mink picked it up from a nearby mink farm, perhaps via wastewater runoff from the farm.”

https://www.vox.com/science-and-health/2020/12/16/21826130/coronavirus-covid-19-in-animals-mink-dog-cats-gorillas-tigers

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COVID-19 Vaccines and Herd Immunity

A very detailed explanation by Marc Lipsitch, Director Harvard’s @CCDD_HSPH (Center for Communicable Disease Dynamics)

https://ccdd.hsph.harvard.edu/2020/12/17/covid-19-vaccines-and-herd-immunity/

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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https://twitter.com/JoyAnnReid/status/1339384156661399552?s=20

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https://twitter.com/RexChapman/status/1339434099153448961?s=20

 

Feel good du jour:

Brilliant strategy, but tragic that it was necessary for an individual to take this on:

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Comic relief:

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Perspective/Poem

https://twitter.com/Goodable/status/1339347458674012163?s=20

Bits of beauty:

 

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2 Comments

  • Joe R McDaniel

    What about using the Ellume test for batch testing? At $5/test, I would just test individually (assuming readily-available test kits], but at $30 and with availability, why not test everyone in the family with one test and only do individual testing if anyone was positive?

    • Judy Stone

      You could readily do batched tests with saliva samples, but Ellume uses a nasal swab, which you wouldn’t want to share. I don’t know if you could use different swabs in the same solution, or too much would be absorbed by multiple swabs and give erroneous results. Some tests require specific kind of material for the swab (e.g. calcium alginate). Interesting idea, but saliva would be the way to go.

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