Volume 11, Letter 15 Coronavirus Update 32
March 29th, 2021
The United States is now likely past 45% of its population having been vaccinated or previously infected. Couple this with warming weather patterns, effective social distancing and we are still in better shape every day.
We are currently vaccinating 3 million people per day. Just under 50 million Americans are fully vaccinated with an additional percentage one dose in. The vaccines continue to be effective against the variants.
As it stands today, the United States has had 31 million cases and almost 548,000 deaths.
There is still no change in the knowledge that more than 80% of deaths are skewed toward the over 55 age group and 94% of all deaths occurred in a person with a co-morbid chronic health disease. More biological antibody medicines are on the horizon that may along with a mixture of vitamin A , D, zinc, quercetin and melatonin be employed for a safe resolution to COVID19. If you did not read the newsletter about an Integrative approach to health in the COVID era, read this link and this link.
As with the first newsletter on this topic, keep solace with the fact that there is a 99+% chance of survival for all of us.
As you reflect on the pandemic a year in, do you see silver linings?
98% said yes
If you have changed behavior based on COVID risk, are you going to maintain it?
84% plan to
Coronavirus Update 32
According to the CDC: fully vaccinated people can:
• Visit with other fully vaccinated people indoors without wearing masks or physical distancing
• Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
• Refrain from quarantine and testing following a known exposure if asymptomatic
The end is in sight. Vaccines are working and restrictions are being lifted for the fully vaccinated. This was a great move by the CDC as the data bears out the extremely low risk (not zero) of any problems after vaccination has occurred.
CDC has changed its school guidance for social distancing to 3 feet instead of 6 feet which is welcome news for those of us that believe that children are low risk spreaders and need to be in in person school environments.
• In elementary schools, CDC recommends all students remain at least 3 feet apart in classrooms where mask use is universal — regardless of whether community transmission is low, moderate, substantial, or high.
• In middle and high schools, CDC also recommends students should be at least 3 feet apart in classrooms where mask use is universal and in communities where transmission is low, moderate, or substantial.
• Middle school students and high school students should be at least 6 feet apart in communities where transmission is high, if cohorting is not possible. Cohorting is when groups of students are kept together with the same peers and staff throughout the school day to reduce the risk for spread throughout the school. This recommendation is because COVID-19 transmission dynamics are different in older students – that is, they are more likely to be exposed to SARS-CoV-2 and spread it than younger children. (CDC Website)
1) To travel or not to travel, that is the question? An excellent article by Emily Oster, an economist from Brown University, in the Atlantic Magazine discussed this topic thoughtfully. The past calendar year has been mentally difficult for all. We know that vacations and travel are a major outlet source for mental rehabilitation for the mentally taxed among us. Therefore, we know that travel is good for the soul. Therefore, the only question left to measure is the risk.
As pointed out in the article, "Children are not at high risk for COVID-19. We’ve known since early in the pandemic that they are much less likely to fall ill, especially seriously ill. Although scientists don’t quite understand why, kids seem to be naturally protected. As a result, you can think of your son or daughter as an already vaccinated grandparent."
The science is crystal clear here. The high risk groups should get vaccinated and/or avoid high risk situations. Once a parent set is vaccinated and past the few week mark post second dose, the risk of getting COVID and/or spreading it is tiny based on all current data sets as covered in the last few newsletters. Children then should not be restricted from travel based on vaccination status of the child. If one personally has objections to traveling until their children are vaccinated, that is reasonable and accepted. The opposite reality also exists. With vaccinated parents and a desire to travel with unvaccinated children, we should consider this reasonable and acceptable behavior.
2) Florida's school reopening experience has been a legislative resounding success according to an article in the Wall Street Journal. (Campos-Flores, A. 2021) A multi month retrospective view shows that reopening has been successful paving the way for more states to follow suit as North Carolina is aggressively doing now. Children should be in school in person nationwide. Their mental health, nourishment and social growth are often dependent on school in person activities.
3) A huge follow up Danish infection study by Hansen in the Lancet provided data that the COVID reinfection rate was 0.65% over 7 months. (Hansen et. al. 2021) This was a very large study with 4 million people receiving 10.6 million tests over the year. We now have multiple studies showing a less than 1% reinfection rate over 6 to 7 months. This continues to add data to the vaccine plus prior infection reality that we are rapidly on a push toward reduced hosts for COVID to infect slowing spread.
4) "Findings from this survey of parents of children aged 5–12 years indicate that parents whose children received virtual or combined instruction were more likely to report higher prevalence of risk on 11 of 17 indicators of child and parental well-being than were parents whose children received in-person instruction. Among nine examined indicators of children’s well-being, five differed significantly by the instruction mode that children received. These differences reflected higher prevalences of negative indicators of well-being for children receiving virtual or combined instruction than for children receiving in-person instruction." (Verlenden et. al. 2021)
Virtual learning should be done away with as soon as possible in all primary school settings. There has been a completely one sided data stream of negativity regarding the children's outcomes mentally and physically. Our in clinic experience mirrors the data. Children are more moody, heavier, less learned and losing ground with health. The only exception has been a major reduction in viral and bacterial illness.
5) 5 Major variants are now in the US: SARS-CoV-2 B.1.427, B.1.429, B.1.1.7, B.1.351, and P.1. The B.1.427/9 are both the California variants that are 20% more transmissible. B.1.351 and B.1.1.7 are 50% more transmissible. Death numbers are not significantly increased in the US to date. None of the current variants meets the CDC definition of variants of high consequence:
Impact on Medical Countermeasures (MCM)
• Demonstrated failure of diagnostics
• Evidence to suggest a significant reduction in vaccine effectiveness, a disproportionately high number of vaccine breakthrough cases, or very low vaccine-induced protection against severe disease
• Significantly reduced susceptibility to multiple Emergency Use Authorization (EUA) or approved therapeutics
• More severe clinical disease and increased hospitalizations (CDC COVID variants)
The hope is that the mutations move slowly while enough Americans are vaccinated and post primary infection to prevent a variant of high consequence that could set us way back.
6) Sleep and host COVID19 vaccination responses. Does it matter? The answer is maybe. (Benedict et al. 2021) It has been long since proven that sleep deprivation or poor sleep quality affects immune activity negatively. Thus, hypothetically, it would follow that vaccination responses would be better for the well rested. Some previous studies have found altered immune vaccine responses to the flu when sleep deprived. The bottom line for those getting vaccinated is this, sleep is important for all human functions. Get 8 hours for multiple days pre and post vaccination to give your immune system the best chance to respond powerfully and correctly.
7) Omega three fatty acids from fish oil are known to be anti-inflammatory and beneficial. Do they matter in COVID19? Hathaway and colleagues reviewed the data in the journal Infectious Chemotherapy. (Hathaway et. al. 2020) In a pilot study of 100 people, they found a 75% increase in COVID death for individuals in the lowest quartile of omega 3 FA intake or omega 3 index. (Asher et. al. 2021)
What this study really says is likely this. The omega 3 index is a marker for overall healthy eating and reduced pro inflammatory SAD processed foods. It in no way proved that fish oil reduces death from SARS2. It also does not prove that fish oil is not beneficial for SARS2 death prevention.
My takeaway from this data is simple. Omega 3 fats and fish oil in specific has strong support for immune health and metabolic function. Immune health equals reduced COVID death. Therefore, I am willing to believe the contention that Omega 3 FA are likely beneficial for viral disease morbidity prevention.
8) "The emergence of SARS-CoV-2 variants highlighted the need to better understand adaptive immune responses to this virus. It is important to address whether also CD4+ and CD8+ T cell responses are affected, because of the role they play in disease resolution and modulation of COVID-19 disease severity. Here we performed a comprehensive analysis of SARS-CoV-2-specific CD4+ and CD8+ T cell responses from COVID-19 convalescent subjects recognizing the ancestral strain, compared to variant lineages B.1.1.7, B.1.351, P.1, and CAL.20C as well as recipients of the Moderna (mRNA-1273) or Pfizer/BioNTech (BNT162b2) COVID-19 vaccines. Similarly, we demonstrate that the sequences of the vast majority of SARS-CoV-2 T cell epitopes are not affected by the mutations found in the variants analyzed. Overall, the results demonstrate that CD4+ and CD8+ T cell responses in convalescent COVID-19 subjects or COVID-19 mRNA vaccinees are not substantially affected by mutations found in the SARS-CoV-2 variants." (Tarke et. al. 2021)
This is another great set of data about the risk the SARS2 variants present for previously infected or vaccinated people. So far so good with the consistent analysis of the variants within the context of a priori viral exposure. We see no increased risk of a negative outcome once vaccinated or having been previously infected.
9) "Findings In this cohort study of 4638 individuals with a measured vitamin D level in the year before undergoing COVID-19 testing, the risk of having positive results in Black individuals was 2.64-fold greater with a vitamin D level of 30 to 39.9 ng/mL than a level of 40 ng/mL or greater and decreased by 5% per 1-ng/mL increase in level among individuals with a level of 30 ng/mL or greater. There were no statistically significant associations of vitamin D levels with COVID-19 positivity rates in White individuals." (Meltzer et. al. 2021)
The vitamin D landscape is flooded with positive and opposing views. Here is another pro study. The simple answer for me is this: what is the risk of supplemental vitamin D to a blood level of 40 ng/ml or direct safe sun exposure to the same for all races? None. Why the debate then? I am not sure other than the scientific purists want conclusive none opposed data. Our first mandate is to do no harm. Vitamin D in normal doses fulfills that requirement. To not recommend it to a deficient or insufficient patient may and likely does cause harm.
This reminds me of the celiac days. Before celiac biomarkers were identified, to recommend a gluten free diet was heresy. Now, commonplace. You decide how you want to live based on the data.
10) "About 87 percent of Covid coverage in national U.S. media last year was negative. The share was 51 percent in international media, 53 percent in U.S. regional media and 64 percent in scientific journals.
Notably, the coverage was negative in both U.S. media outlets with liberal audiences (like MSNBC) and those with conservative audiences (like Fox News)."(Leonhardt D. 2021)
This article shows us what we already know to be true. The media outlets in this country sensationalize and skew the story for maximum negative impact to drive ratings and viewership all the while painting pictures that are factually cherry picked.
Dreaming of a day where journalism returns to facts only!
11) A good article in Nature on the ability of SARS vaccines to provide longer term benefit. (Burton et. la. 2021)
Oster Atlantic Magazine
Hansen The Lancet
CDC COVID variants
Lancet Resp Medicine
Hathaway Infectious Chemo
Leonhardt New York Times
Burton Nature Medicine