November 27, 2020

the day after

13,000,000 cases, 265,000 deaths, one million new documented infections in a week. After the holiday, I expect things to accelerate even more; but due to the holiday, the numbers may not increase right away. The data will take a few days to catch up. I hope that everyone that traveled does a quarantine afterward to prevent spreading the virus. But that is probably too much to hope for.

Now we all need to rethink our actions and habits and not get sloppy. I admit that earlier this fall, I did act more cavalierly about my possible exposures. I was feeling pretty safe in Seattle. But not so much now when the percent of positive tests is approaching 10%. I have woken up again and am back on the prevention train. I am concerned about patients coming to clinic with asymptomatic infections; but, really, I am more concerned about the staff and where they spent this past weekend. Now is a good time to review your masks and make sure you have a good fit and are wearing them correctly. Neck gaiters are OK, even better if you can fold it and double the layers. The important thing is to wear something that can filter. The Danish Study has once again added confusion to the efficacy of mask wearing. Remember, masks definitely prevent the wearers from spreading SARS-CoV-2, which is why we wear them. This article explains it better than I can.

I know we have all been concerned about the rapidity of the vaccines, wondering if corners have been cut in the push for approval. Two things to think about right now. One is that the AstraZenica vaccine has a surprise issue that has come out the past two days. The lower dose that was given that has been shown to be more effective was actually a dosing error which was discovered later, but surprisingly showed more effectiveness. Interestingly this is often how breakthroughs happen- through errors or mistakes. But still, this has given many pause about this specific vaccine, although I am still intrigued about using different doses for better effect.

There is another detail that gets overlooked when we talk about how fast these vaccines are showing effectiveness. Usually vaccines take years for approval because there are not enough cases to show effectiveness in prevention. That is what happened with the SARS-CoV-1 virus, the virus causing SARS. SARS was contained and disappeared so that there were not enough infections to show effect. The same with the Ebola vaccine. But SARS-CoV-2 is a different case. Because of the extent of the pandemic and how many people have been infected worldwide (more than 61 million cases so far), proving the effectiveness of the vaccine is so much easier. This is a big reason the data show effectiveness so much faster than past vaccines.

We are all hurting and adapting to these new ways of life. Small business and restaurants are really hurting. If you are doing ok and able, find ways to help small businesses in your areas. Order books from local stores, get takeout and tip well, buy local. I feel so much gratitude on a daily basis that Jamie and I landed in a neighborhood that has a sweet little grocery store that we feel safe shopping in and a small hardware store just blocks away. We also have a book store and not far from the post office either. We shop at those places instead of the big box stores or on line, if we are able. Support your favorite musicians, many are doing shows on line. And donate if you can to charities and programs you care about. We want all of these to survive a few more months until things start to open up safely.

Wash your hands, cover your nose, keep safe six, and be generous. You will feel better for doing so.

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.

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

https://covidtracking.com/blog/daily-covid-19-data-is-about-to-get-weird

https://www.seattletimes.com/nation-world/a-short-guide-to-quarantining-after-holiday-travel/

https://www.seattletimes.com/seattle-news/health/what-type-of-mask-works-best-and-how-to-wear-it/

https://www.medpagetoday.com/blogs/vinay-prasad/89778 danish mask study

https://www.washingtonpost.com/health/2020/11/17/covid-vaccines-what-you-need-to-know/

https://www.nytimes.com/2020/11/25/business/coronavirus-vaccine-astrazeneca-oxford.html

https://www.seattletimes.com/business/9-ways-to-support-small-businesses/