COVID Transmissions for 9-18-2020
Good morning! It has been 305 days since the first documented human case of COVID-19.
Today is the eve of the Jewish new year of Rosh Hashana. I am very much eager to put this year behind me. If you’re not Jewish but in need of a new year anyway, this time around at least I’m happy to let you borrow ours.
Just headlines today—I have a lot of holiday preparations to do.
As usual, bolded terms are linked to the running newsletter glossary.
Keep the newsletter growing by sharing it! I love talking about science and explaining important concepts in human health, but I rely on all of you to grow the audience for this:
Now, let’s talk COVID.
Vaccine confusion
There has been some confusion over when a vaccine might be coming.
First, the CDC was reported to have told certain healthcare organizations to prepare for a vaccine to be available in October. Then, Pfizer indicated that they might have results from their Phase 3 trial as early as late October.
However, in his Senate testimony earlier this week, Dr. Redfield indicated that the general public should not expect to see a vaccine until the spring or summer of 2021. This earned immediate pushback from President Trump on twitter, of course.
What’s going on here is that there is confusion over what the earlier statements meant vs this new statement. The instruction from the CDC to prepare for a vaccine was likely to encourage healthcare organizations to be ready because a vaccine for their workers might be available that early, or it might not.
The Pfizer statement was just that early data might be available; there will still be a need to review these analyses at the FDA, if they are still doing that kind of thing when it comes to COVID-19 vaccines. There will also be a certain amount of time it will actually take to get doses to market—they’re not sitting in doctor’s offices and hospitals right now. Speeding that process up might be why the CDC told healthcare facilities to prepare.
Given the potential for supply chain issues and the expected demand for this vaccine, it’s not unreasonable to expect its general availability in the spring of 2021. In fact, that’s essentially when I predicted it would become available in an earlier edition of this newsletter, provided everything goes right. However at the time I noted I was being very speculative. I still am.
Viral load correlates with likelihood of death
A paper published in Cancer Cell—for reasons I don’t fully understand, it’s not about cancer—looked at viral load in patients with COVID-19 and determined that the more viral load a patient had, the more likely they were to die. This is not a big surprise. Traditionally, viral load is the amount of virus you have in the target organ. More virus usually means more severe disease.
Their top-line results:
Overall, the in-hospital mortality rate was 38.8% among patients with a high viral load, 24.1% among patients with a medium viral load, and 15.3% among patients with a low viral load (P<0.001).
Now, they used PCR to measure viral load, so they may not actually have been measuring viral load in the traditional sense. Instead they are measuring virus RNA products, so they may be detecting defective particles or something else that is made in large volumes in patients with severe disease. Still, it’s interesting! Perhaps this can be used to triage patients to improve survival by identifying those in danger more quickly.
Full paper here: https://www.sciencedirect.com/science/article/pii/S1535610820304815
What am I doing to cope with the pandemic? This:
Preparing for Rosh Hashana
This is typically a time of Jewish reflection. I have been very fortunate this year, in a time when many others have not been. I have survived a local epidemic in a global pandemic, started an exciting new job and survived a layoff, lost 35 pounds, and generally achieved quite a lot.
It’s valuable to remember these good things, but also likewise it is healthy to acknowledge that this year has been difficult, for me but also for others close to me. There are friends who I began this year with who are not going to be seeing the end of it.
I’m hoping that we can learn from the tragedies of this year to make a better world.
Join the conversation, and what you say will impact what I talk about in the next issue.
Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.
This newsletter will contain mistakes. When you find them, tell me about them so that I can fix them. I would rather this newsletter be correct than protect my ego.
Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.
Correction: There some minor typos in the piece about Dr. Redfield’s statement regarding masks yesterday. I’ve corrected them in the online edition. Thanks are owed to the reader who pointed them out.
Thanks for reading, everyone! Shana tova (a good new year) to those celebrating.
See you all next time.
Always,
JS