March 24, 2021

not over yet

The last year is a blur in many ways, but also there are moments with sharp contrast. I am glad that many of my memories of my pandemic year are documented in this blog. I have taken to reading my posts from a year ago to remind me. We have come far, better and worse than expected. Last year at this time we feared a million deaths, we didn't yet know the actual case fatality rate or how to treat people with COVID-19 to support them though their illness. There were no medicines shown to help and vaccines seemed a far off distant dream.

We have come a long way. The mortality rate has dropped since the devastation at the beginning. partly from sharing what worked with others. This collegial sharing made a difference. Also, the studies showed that new medications worked, such as new monoclonal antibodies and the anti-virals. We now have vaccines, designed, tested, studied, and proven effective and safe in record time. More than one, several in fact. Astonishing. The vaccines have proven to work very well in health care workers. Several studies have shown that the “jabs” worked well, which helps lower stress in the very stressed and fatigued front line workers.

More and more people are getting vaccinated and intent to get a vaccine is rising as they prove safe and effective. More importantly, the rate of adherence to get the second vaccine is very high. Now that the Johnson and Johnson is available, the second shot is moot for those that get it instead of Pfizer or Moderna.

But the pandemic is still ongoing. Even today there were 79,000 new cases and 1591 deaths in the US. Breakthrough infections after vaccination are rare, but occurring, even after vaccination. Remember the effectiveness is 95%, not 100%, at preventing illness. That 5% makes a difference. Plus the new variants can increase transmission. Generally these breakthrough infections are mild, but they have the potential to infect the unvaccinated or develop a new variant of its own.

Which means vaccines alone can’t control the pandemic yet. A fourth surge is still possible before more people are able to get their vaccine. The new variants complicate the situation further. This mainly means we must still be careful, wearing masks and social distancing a little longer. If you are fully vaccinated, you can be with a small group of people who have all been vaccinated without masks, as the CDC says. But this is a reminder to be aware of who you may be with later. The vaccines still protect from serious illness and death, which helps. But remember that many people are still not protected by the vaccine so they are vulnerable to complications.

Wash your hands, cover your nose, keep safe six, “it ain’t over ‘til its over” *

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

* Yogi Berra

https://betsybrownmd.substack.com/p/march-24-2020

https://www.jwatch.org/na53330/2021/03/18/hospital-covid-19-mortality-fell-during-first-6-months

https://www.medpagetoday.com/infectiousdisease/covid19/91774

https://www.jwatch.org/fw117643/2021/03/23/covid-19-mrna-vaccines-show-high-effectiveness-among

https://www.empr.com/home/news/complete-covid-19-two-dose-vaccine-series-cdc-completion-rate/

https://www.cdc.gov/mmwr/volumes/70/wr/mm7011e2.htm

https://www.verywellhealth.com/vaccine-sentiment-tracker-covid-symptoms-vs-vaccine-side-effects-5116655

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

https://www.theatlantic.com/science/archive/2021/03/vaccine-breakthrough-cases/618330/

https://www.seattletimes.com/nation-world/vaccinated-people-can-get-covid-but-its-likely-very-rare/

https://www.sciencedaily.com/releases/2021/03/210318142500.htm

https://www.mdlinx.com/news/a-4th-coronavirus-surge-is-threatening-the-us-due-to-a-list-of-reasons/6Ts1zdNHsYb0JnrVRamrLk