Shiny Object

            “I think the bottom line here is that the interventions that are needed to prevent the spread, regardless of which variant it is, are the same, and I think that’s key and that’s where we should be focusing. While scientists are still doing the lab experiments to figure out what are the implications of this new variant—Does it really enhance transmissability as has been suggested? Does it really prevent antibodies from binding to the virus? Will it have any implications for vaccine efficacy?—these are still questions that scientists are hopefully going to answer in the coming days and weeks.” Dr. Soumya Swaminathan, MD, World Health Organization Chief Scientist, on Bloomberg Television, December 21, 2020

            “I think it’s pretty likely that social distancing and wearing masks will be helpful for this period. I mean, [the new strain] doesn’t have magical powers. If people aren’t near each other, it can’t spread. So this is a moment when you have to really realize that it’s both the vaccine and what we do that drives the population rate down, and as that comes down, we get to do more things in our lives. So, it’s, you know, a real sign that it’s not enough just to wait for the vaccine.” Dr. Joshua Sharfstein, MD, Johns Hopkins Vice Dean for Public Health Practice, on Bloomberg Television, December 21, 2020.

            “We’ve learned a lot in the last year about how to treat patients. We have therapies, modalities such as steroids, which reduce the risk of mortality 20, 30 percent. So we don’t have any game changers or homeruns on the forefront of therapeutics at this point. And so we’re gonna have to rely on public health, you know, sound public health prevention to get over this period. It’s gonna be a difficult next several months during these winter months as this surge is occurring, not only in the United States but in many parts of the world.” Dr Albert Ko, Professor of Epidemiology and Medicine and Chief of Medicine, Yale Medical School, on Bloomberg Television, December 24, 2020

Credit: Andrzej Wojcicki

Dear Students,

I’m going to keep this short, because of the holidays—the quotes above say it all—but also because of the holidays, I can’t not do it. There is too much danger around us right now.

A new type of SARS-CoV2 has been found in southern England. It is referred to by the British scientists as a VUI—Variant Under Investigation. There is limited evidence that it may be more transmissable, possibly 70 percent more, than previously identified variants. It has 23 mutations that have been seen in other variants, but not together. Some experts are skeptical that higher transmissibility has been proved.

Sealing the UK off from the rest of the world seems simply too late to do effectively now. The most likely reason it was found in the UK is that the UK does more viral genetic sequencing than any other country, far more than we do. Especially if it is indeed more transmissable, it is probably already in many other countries, including ours.

What can you do about it? What I hope you have been doing all along: masking, social distancing, handwashing, and avoiding social gatherings, including small ones that include people from two or three households. If you have been slacking off, stop slacking off and double down on all precautions. For our country, this is the worst time so far, by far.

The photo shows a shiny object that is distracting many people. Forget about those who are fool enough to reject the vaccine. I’m talking about those who feel complacent because they think the vaccine has already saved us. Not even close. That’s the point of the hourglass in the syringe. For each one of us who gets a first dose, the jab comes with a four to five week delay until protection.

For the country as a whole, it comes with a delay of six to eight months. That means we will not only not have protection as a nation, we will actually be in worse shape for the next two to three months than we have ever been before, or for that matter worse than any nation in the world has ever been before.

Because you see, although the vaccine’s scientific development has been Operation Warp Speed, the distribution will be Operation Snail’s Pace. I heard someone on TV brag today that we’ve vaccinated a million people already! In just ten days!

Good luck getting back to normal at that rate. Of course, it will increase. There will be millions by New Year’s Eve. But we need scores of millions right now, not millions, and we will need hundreds of millions to get back to normal—July 1st, if everything goes according to the non-plan. If it doesn’t…

Yes, the non-plan. There never was a plan for distribution, and there isn’t one now, not a national plan. This past week the White House finally got an order in for a decent number of vaccine doses. Manufacturing will start on that order, and…and…

If there had been a plan, especially if the Defense Production Act had been invoked to start producing the number needed, as could have happened long before approval—it was just a matter of money to make and store them—then we would be deploying scores of millions of doses now.

But there was no plan and the DPA was not invoked. So we face the worst now, for two to three months, and a pandemic that lingers, worsening until spring, then tapering slowly until summer.

Don’t get me wrong, the vaccines are great. They are very safe and highly effective. I would take either of the mRNA vaccines (Pfizer and Moderna) already deployed right now, today, if I could. In fact I would take my chances with either of the adenovirus vaccines (Astrazeneca and Johnson & Johnson) that haven’t even finished clinical trials.

The science behind them did not begin this year, it began with SARS-1 in the early 2000s. It’s being finished this year. What’s not going to be finished until the middle of 2021 at best is delivering this great science into the arms of the American people, and making our lives whole and normal again.

So it’s still up to you. Protect yourself and your loved ones. Protect neighbors and strangers too. Don’t be distracted by the shiny object in the photo. It won’t bring normality any time soon. It won’t even bring safety. Only you can do that.

Have a safe and happy holiday season by not trying to have a normal one. Live, and help others live, to celebrate normally next year and for many years after.

Be wise and stay safe,

Dr. K


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