December 13, 2020

A truck loaded with the Pfizer-BioNTech COVID-19 vaccine leaves the Pfizer Global Supply Kalamazoo manufacturing plant in Portage, Mich., Sunday, Dec. 13, 2020. (AP Photo/Morry Gash, Pool)

The first trucks loaded with Covid-19 vaccine have left the Pfizer plant in Portage, Michigan and are careening down the nation’s interstates bound for an overly stressed health system.  With the FDA having granted an Emergency Use Authorization, the first shots will be administered tomorrow, predominantly to health care workers on the front lines of caring for victims of the pandemic.  When you think about it, it’s rather astounding that we have come so far, so fast.  The disease was unknown a year ago, was not established in the US until about ten months ago, and only entered most Americans’ awareness about nine months ago.  Generally, it takes a decade or more of meticulous research to create something like this vaccine and it was done in less than a year.  It shows what human beings can do if they band their collective ingenuity together to solve problems in a crisis.  Now if we would just put our minds together and start working on some of the other issues that are tearing our world apart.

There are more than a few myths surrounding the vaccine and what its impact is going to be on the continued battle against Covid-19.  First, it is not a panacea and the pandemic isn’t going to be over and everything isn’t going to return to the way it was next week.  Even if a significant portion of the population is inoculated, the virus is entrenched enough to continue spreading and the basic mitigation measures of masks, hand washing, social distancing, and avoiding of crowds in enclosed space are going to be necessary for a while longer.  What’s ‘a while’?  I don’t know but I suspect that the earliest that these sorts of things will be able to be relaxed is this coming summer and it could be considerably longer than that.   Second, despite propaganda coming out of the current administration, the vaccine has nothing to do with them or their actions.  It was developed by a small German company BioNTech, founded by Turkish immigrants, founded to look at the promising new fields of genetic engineering using mRNA.  Pfizer came on board for upscaling of manufacture and distribution.  Neither company took federal money nor was part of the administration’s much touted ‘Operation Warp Speed’.  Third, it’s not going to be universally available to the general public for quite some time so don’t harass your pharmacist down at the CVS.  The vaccine is under federal control and is being allocated to states based on various criteria such as population, the availability of facilities to safely ship and store the vaccine (which must be kept at super cold temperatures), and disease spread.  Alabama is receiving something like 40,000 doses for a population of nearly five million.

There is trepidation in certain quarters about the new mRNA technology used in the vaccine.  This is a way of introducing small bits of mRNA into human cells and turns their own protein manufacturing abilities into creating antigens which the immune system then builds antibodies to.  It’s a nifty idea, works fine on paper and the studies submitted to the mRNA show good efficacy and minimal side effects.  There are questions as to whether, in certain individuals, this could cause the immune system to react too robustly and make people sicker than the disease would, if the studies really included enough elders with chronic health conditions to know what the vaccine will really do when introduced widely to that population, and if the issues with transport and storage will allow for equitable distribution.  I can’t answer any of these questions at this time and will continue to monitor news and science sources for additional information as it becomes available.  Those I know personally with great experience in infectious disease are saying ‘take the vaccine’ unanimously so I’ll do so when it becomes available to me.  It’s likely to be a condition of continued employment.

My handy dandy coronavirus counter shows that we’re up over 16 million cases in the US.  It only took four days to add the most recent million.  National deaths are at nearly 300,000 and are over 3,000 daily.  Here in Alabama, we’re at over 4,000 deaths and 300,000 cases.  Every hospital in the greater Birmingham area is full.  My colleagues are exhausted.  I received at least one notice daily last week about a long-term patient of mine being admitted with a serious case.  I expect most of them to die. My social media news feed is full of notices of friends asking for thoughts and prayers for their parents, siblings, neighbors, and other connections who have fallen ill. We’re just over two weeks out from Thanksgiving so at the peak for cases fueled by travel and gathering.  The peak for hospitalization hasn’t hit yet and the peak for dying will come sometime after that.  You can gather for Christmas, and continue to contribute to these numbers, or you can come up with some clever alternatives.  The life you save may be your own.  At my house, it’s going to be Zoom Christmas with the family and just me and the cats present in person.

It’s not all doom and gloom at my house.  I’ve had several very productive conversations with a book editor about turning these Accidental Plague Diaries into book form and am diving into that project.  I just wonder if anyone really has any interest in reading it after having lived it.  My Christmas present to myself, a Peloton, has arrived and I am getting in my daily cardio (my primary care physician is thrilled).  I made myself several gallons of mulled cider using Tommy’s recipe that I was actually able to recall from memory and it turned out OK.  For my next trick, I’m going to try Bates Redwine’s and Hal Word’s eggnog using the fifth of Southern Comfort that’s been taking up space at the back of my liquor cabinet for the last decade.  After a dry spell for the last few months, I’m feeling creative again and that usually means something interesting should burst forth.  I don’t know what it is yet, but with luck it’ll help with the trying time we all find ourselves in.

Be safe.  You know what to do.

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