The END is In Sight
As a family physician, I am just about ready for all this pandemic business to be over. You, too? So there are two of us.
And here’s a word of hope: The END is In Sight.
Granted, the end may be a tiny speck on the horizon, but it’s getting bigger, bit by bit. And yes, that end prominently involves vaccines (more on that later), but it also involves fewer people catching COVID now. And what can you do to avoid COVID?
1. Wear a mask when indoors with people not in your immediate household.
2. Avoid indoor spaces wherein there are people who are not wearing masks.
3. In an indoor space, stay six feet apart from people as much as possible.
4. Definitely stay six feet apart from a person outdoors if one of you isn’t wearing a mask.
And now, a word about mask wearing. If the mask is below your nose, you are essentially not wearing a mask. As a family physician, I ask some patients to pull up their masks twenty times during the visit. In their defense, some masks work their way down below the nose when people talk. This seems especially true with a mask made of thick spongy fabric — perhaps neoprene? — that many people have. If a mask won’t stay above the nose, my advice is to toss it.
More mask observations: More and more I am seeing people wearing masks with vents. Those types of masks are to protect people working with dust. That is, you breathe in through the mask material (filtering the air), and breathe out through the vent (no filter). Thus you are protected from virus other people are breathing out, but nobody around you is protected from any virus that you may be breathing out.
Final mask thoughts: Any time you touch your mask, you need to either wash your hands or use sanitizer gel. Every. Single. Time. I keep a little bottle of alcohol gel in my pocket (and when it’s empty I refill it from a larger bottle) and use it often if I am out of my house. Cloth masks should be washed daily. And please (pretty please) do not remove your mask to talk. That is when you need to be wearing it the most.
Several vaccines are coming to the finish line after being carefully tested for many months. The most important test for a vaccine — the “Phase 3 trial” — involves tens of thousands of people, with about half of them getting the vaccine and half a placebo. The question to answer in a Phase 3 trial is, “Did getting the vaccine actually protect people from getting sick?”
The answer, at least for the two mRNA vaccines that have recently released some results, seems to be a resounding “Yes!” Pfizer already has enough information to apply for an Emergency Use Authorization (EUA) so it can begin distributing its vaccine. Their press release https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-conclude-phase-3-study-covid-19-vaccine reports a 95% efficacy of the vaccine over the placebo. This is tremendous success. What they were hoping for was at least 80%.
In September, I wrote about being in Pfizer’s Phase 3 trial https://cmda.org/a-vaccine-trial-is-not-a-trial-what-participating-looks-like/ after I had gotten the first shot. My body’s response to that shot was so minimal (a mildly sore arm at the injection site that began 27 hours afterwards, and only lasted a few hours) that I highly suspected I got the placebo. The second shot, three weeks later, was a different story. At the injection site I had a red blotch the size of a deck of cards, and it was sore and warm. The whole next day I had a low grade fever and a numbing fatigue that made it hard to get up off the couch. So I didn’t. Get of the couch, that is. And lying there with my body being a blob, my mind was jubilant. Surely I had gotten the vaccine. Could a salt water injection do any of that?
The side effects lasted one day and then I was fine. Last week, five weeks after the second shot, my curiosity got the better of me, and I got myself rapid-tested for COVID antibodies. My test was strongly positive. I did a little happy dance.
So is Pfizer’s mRNA vaccine safe? When a vaccine has caused a problem in the past, it almost always happens in the first six weeks. That amount of time has passed for most of us in the trial, and I haven’t heard of any problems. The side effects I described above, even though they cost me a day of productivity (happily it was a Saturday), are considered mild and transient. I am 62. Apparently side effects are likelier in younger folks.
I think the mRNA way of making vaccines is safer than most. The immune response is mounted against only a single protein, so there are fewer cross-reactions. And how does the mRNA vaccine work? It is a “plug and play” system that has been in development for over a decade, though these are the first human vaccines to come to market. I will pull from my previous article and quote myself:
“(Once you) figure out what protein you want to make, (you) insert the code for making that protein into mRNA.
Because of previous experience with coronaviruses, scientists knew the spike protein on the surface of the virus needed to be the target for vaccines. Coronaviruses use their spike proteins to enter cells, so if you have antibodies to the spike protein, you can stop them in their tracks.
The spike protein alone is harmless. It takes the entire virus to be able to infect the cell. So mRNA vaccines work by putting the code to make the spike protein into mRNA, coating it with a fatty layer (so it gets past the cell membrane) and injecting it in the recipient’s arm.
The mRNA takes it from there. Once inside the recipient’s cells, it starts churning out the protein, and when that protein is displayed on the outside of the cells, the person’s own immune system kicks into gear. B cells make antibodies to the spike protein, and T cells make memory cells.”
Both Pfizer’s and Moderna’s vaccine use mRNA, and both look like they will be 95% effective. And even though I strongly suspect I received the vaccine and am protected from catching COVID, I am not going to let my guard down. 95% is not 100%. That is, five out of a hundred people who received the vaccine still became ill with COVID-19. I don’t want to be one of them.
So I will continue to wear a mask, keep my hands clean, and maintain a “social distance”. And I look forward to the day when enough people have been vaccinated so that this nasty virus stops infecting and killing so many precious people.
Vaccines save lives. They also stop pandemics. The END, as I say, is In Sight.
