I believe that medicine’s potential is much more than the version we see in the world today. A doctor should be an educator with the goal of bringing patients to a place of deeper understanding of who they are in the world. To me, medicine is ultimately about self-empowerment through self-knowledge and growth.
Developments with the novel coronavirus continue to reveal themselves.
First, we’ll do a COVID update then a review of the state of the variants and vaccines. Finally, we will conclude with a peek at what the radical thinkersare saying.
The Berkshires’ case load went up 182 cases over the last week. Berkshire County currently has reached a high transmission designation, according to the Centers for Disease Control and Prevention, which recommends wearing masks indoors, regardless of vaccination status, at substantial or high transmission levels.
Massachusetts Education Commissioner Jeff Riley issued new regulations this week requiring all public school students ages 5 and above, and all staffers, to wear masks indoors while at school.
Nationally we are plateauing as far as new cases. We have stayed in the 150K new cases per day range. The South appears to have peaked. Mississippi has seen cases start to drop.
FDA gave full approval to Pfizer’s mRNA vaccination this week.
What do we know about the variants and what are we watching?
Delta is more contagious than alpha or the original strain. With the original strain for every person sick with COVID two to three people became infected. With Delta the number is seven or eight people that get infected for each positive.
There remains no evidence that Delta is more lethal than its predecessor strains.
Lambda is suspected by many to be more contagious than Delta. The general historical trend with a novel virus is that it becomes more contagious and less virulent as time goes on. It remains to be seen whether or not this trend will be seen with SARS-CoV-2. One factor that makes this outbreak different than any other is that we are mass vaccinating in the middle of an outbreak, something that has never been done before. (More on this below).
The vast majority of people who are infected survive, vaccinated or not. That’s a nice thing to remember. Vaccination makes severe illness less likely and also makes contracting COVID less likely, but it is not without adverse effects (rare but not trivial) including serious adverse events.
Newest understanding indicates our current vaccines are likely to offer a 180-day window of protection.
COVID Radical Ideas
One of the many voices I have been following during the pandemic is a man named Robert Malone. He has a very well-qualified resume and has shared a number of observations in a recent Washington Times editorial. He is controversial because he challenges the status quo but many of his points are backed by leading virologists (UK and US).
The gist of his stance is as follows:
1) Due to Delta’s contagiousness and the degree of breakthrough cases, herd immunity cannot be achieved through these vaccinations because the vaccines don’t block infection sufficiently enough. He claims the CDC’s information backs this up.
2) Training a large proportion of the population’s immune system to hone on one viral target while the infection is still wide spread is actually driving the existence of viral variants. As he says in the editorial:
“when the virus infects a person with a “leaky” vaccination, the viral progeny will be selected to escape or resist the effects of the vaccine.
If the entire population has been trained via a universal vaccination strategy to have the same basic immune response, then once a viral escape mutant is selected, it will rapidly spread through the entire population — whether vaccinated or not.”
Because more contagious variants are being driven by something other than the natural evolution, we can’t be certain that the historical observation of less virulence accompanying increased contagious will hold true.
3) If left unchecked a strategy of universal vaccination could create a scenario of more variants and a circumstance where the vaccine could eventually be ineffective. He recommends a strategy to selectively vaccinate the world’s vulnerable populations and aggressively invest in early (even self) diagnosis and early outpatient treatment. He sees promise in repurposed drugs like Pepcid, Celebrex, ivermectin, and fluvoxamine (an antidepressant). The pharmaceutical industry is also developing early treatment options.
Whether you agree with his assertions or not, we need the voices of these qualified virologists and pandemic-ologists to be at the table. The biggest threat to future success is suppression of true scientific debate in the name of protecting us from misinformation. It’s a formidable task because there are agents of chaos that flood our airways with harmful intent. And the internet and social media and their algorithms make us more accessible and susceptible to nefarious influences. How to protect scientific debate while not giving airtime to toxic ideas is our biggest challenge. Certainly our best effort and deliberation and striving is needed, as always.
Much of what you have been doing to mitigate your exposure will continue to serve you well. Continue to be smart in public spaces and know that ventilation (outdoors being a key), physical distancing, vaccination, small pods of exposure, and masking all continue to have a place.
Wishing you the best on finding the most unapologetically courteous approach! We will get there.