magine a highly contagious virus circulating in the community. Many infected children have fever and some general misery but recover without incident. Rarely, devastating complications occur, leading to hospitalization, severe illness, and occasional deaths.
By the thousands, U.S. service members are refusing or putting off the COVID-19 vaccine as frustrated commanders scramble to knock down internet rumors and find the right pitch that will persuade troops to get the shot.
You chair the Governor’s task force on rollout of the Covid-19 vaccine. Given concerns about the limited availability of the two-dose mRNA vaccine, you have been asked to weigh in on the debate regarding the most effective use of the currently available doses. Should people who have already received a first dose of vaccine have their second dose delayed by a number of months until there is a greater supply, so that more people can receive a first dose? Or should those who have gotten the first dose receive the second dose according to the standard schedule, 3 to 4 weeks after the first dose, as recommended by the Food and Drug Administration (FDA)? You must consider the benefits and risks of the two approaches, on both individual and population levels, and decide what to recommend to the task force.
Since autoimmune diseases are so common in women, I’ve long waited to see if there were specific recommendations for Covid-19 vaccinations in patients with these underlying family of illnesses. The answer is “no.” Unfortunately, this is based on hunches and physicians’ experiences, rather than solid data. The American College of Rheumatology (ACR) just released their recommendation: “Although there is limited data from large population-based studies, it appears that patients with autoimmune and inflammatory conditions are at a higher risk for developing hospitalized COVID-19 compared to the general population and have worse outcomes associated with infection,” said Dr. Jeffrey Curtis, chair of the ACR COVID-19 Vaccine Clinical Guidance Task Force. “Based on this concern, the benefit of COVID-19 vaccination outweighs any small, possible risks for new autoimmune reactions or disease flare after vaccination.”
Pregnant women in Washington state were infected with COVID-19 at a 70% higher rate than others of similar ages, with nonwhite women shouldering a disproportionate burden, according to a study published yesterday in the American Journal of Obstetrics & Gynecology.
Large cell nuclei that appeared to be megakaryocytes were found in cortical capillaries of five people who died with severe COVID-19, neuropathologists reported.
All three patients described were able to avoid ICU admission. A 60-year-old woman presents to hospital in St. Petersburg, Russia, with symptoms of SARS-CoV-2 infection for the previous 14 days, including persistent dry cough, weakness, and intermittent fever. She also notes that she has been urinating much less than usual.
Official Reporting for February 18, 2021
World Health Organization
Confirmed Cases: 109 217 366
Deaths: 2 413 912
Confirmed Cases: 109,872,348
Total cases: 27,600,391 (+57,970 New Cases)
Total deaths: 486,466 (+1,396 New Deaths)
Science and Tech
A significant and positive outcome of the COVID-19 epidemic is the speed at which many members of the biological research community have been able to redirect and apply their specialized skills towards an increased understanding of SARS-CoV-2. The rapid pace of publication and sharing of data, however, brings new concerns: what aspects of coronavirus biology are now well documented and understood, and what areas represent “black boxes” where there is inadequate research coverage or conflicting results? How trustworthy are the currently available data, and how close are we to having a consensus model of different stages of the SARS-CoV-2 life cycle?
The White House plans to increase testing capacity in the U.S. through multiple channels, officials said in a media briefing on Wednesday.
Psychological and Sociological Impact
As the virus has torn through Israeli society, it has caused a collision between mainstream Jews and the ultra-Orthodox minority that The Times is documenting.
Clarifying the evidence on SARS-CoV-2 antigen rapid tests in public health responses to COVID-19 – Lancet
Challenges in interpreting SARS-CoV-2 serological results in African countries – Lancet
Misinformation, Disinformation, and Conspiracy Theories
In September 8, 2020, AstraZeneca announced that it was pausing its late-phase SARS-CoV-2 vaccine trial because of a serious adverse event in a U.K. participant. The next day, my hairdresser, Ms. J., asked me what I thought about the news. I said the halting of the trial to investigate the adverse event was reassuring — an example of science doing its job. “What do you think?” I asked.
Coping in 2020 (and probably most of 2021)