Again we begin with the normalized incidence. One should remember that the over 60 group is now almost 75% immunized so the incidence is amongst the younger 18-30 year olds. Anecdotal evidence regarding the "Spring Break" in Florida attributes the crowd to people having their relief checks and not college students who had no spring breaks. Interesting speculation and if true the Government seems to be incentivizing the spread! Not at all surprising however. Now the data:
We have argued for months that variant tracking must be done. However as the NY Times reports:
The White House on Friday announced an almost $2 billion plan for expanding and improving the nation’s ability to track coronavirus variants, an effort that public health experts have said is desperately needed to fight against variants that could drive another wave or potentially undermine the effectiveness of vaccines. More than half of the funding, $1 billion, would go to the Centers for Disease Control and Prevention and states to monitor those variants by examining positive virus test samples. The tracking relies on genome sequencing, in which researchers read every genetic letter in a coronavirus’s genome to find out whether the virus belongs to a known lineage or is an entirely new variant with new mutations. That money will be steered to the collection of samples and sequencing, then sharing the data with health officials and scientists, the White House said. The C.D.C. has so far leaned heavily on commercial laboratories to conduct that work.
Namely the Government is making two fatal mistakes.
1. They are relying on the CDC. The CDC has repeatedly demonstrated their gross incompetence across this pandemic. Instead using a network of commercial labs is essential and it is currently working. Why stop something that is working and give it to a demonstrably incompetent group.
2. The data should be public in a public open data set. Again no CDC. Remember the CDC grossly messed up the system to obtain vaccines. Keep them away from data. Do not limit access to select groups. In today's world, data must be open and anyone can analyze it. Government should try a little to be transparent.
This proposal is just another step in fumbling the ball. The CDC is the problem and not the solution.
The recent concerns about the adenovirus vector vaccine and clotting is of some interest. The above is the classic clotting mechanism as studied in First Year Med School. In reality it is much more complex but the above gives some insight. The problem is that not everyone is the same and small genetic differences can exacerbate clotting, namely reduce or increase it.
Several articles in NEJM have recounted clinical evidence. The first notes:
Vaccination with ChAdOx1 nCov-19 can result in the rare development of immune thrombotic thrombocytopenia mediated by platelet-activating antibodies against PF4, which clinically mimics autoimmune heparin-induced thrombocytopenia.
and the second notes:
We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4–polyanion complexes; however, they had had no previous exposure to heparin. Because the five cases occurred in a population of more than 130,000 vaccinated persons, we propose that they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia that we refer to as vaccine-induced immune thrombotic thrombocytopenia.
It appears that a specific Ab is the cause. We had addressed this issue a while back. The issue then is; doe we now tests for the Ab factor or do we try to find what the adenovirus does to start the thrombotic chain?
1. The virus can be mitigated by vaccines. Namely the initial WT virus. It appears that the vaccines are also reasonable against the variants.
2. Mutations occur most in immunocompromised individuals and they should have been vaccinated first. Not so much it appears. But it is not just in the US but globally. For example malaria does impact the immune system thus plasmodium infected persons can present as pools for mutations and variant production.
3. Vaccines prevent infection. Namely if a person is subjected to a viral assault the virus in the lungs is attacked. That is where it is active at 98F. However the virus in the nasal passages at 94F is dormant and can spread. It would not mutate but it could infect an un-vaccinated person.
4. We MUST track the variants and we MUST modify the mRNAs to target them as they are identified
5. Vaccinations must become periodic. This is NOT a ONE-OFF approach. Like flue vaccines but even more so they must be addressed periodically.
6. International travelers MUST be traced and tested for carriers status. We did this a century ago and it worked. We must accept this to prevent variant introduction.
Overall this is very doable but the concern is that the CDC is a political organization not it appears a competent public health entity. Politics seems to be dominating the overall process. It must change.
Finally, being somewhat expert in wireless, 5G did not cause the pandemic and 5G is not tracking those of us vaccinated. The Government has much better ways they are using already!
One must be careful in interpreting the data since we now have 50% immunized via on or more vaccine injections and those already infected. This is best seen below. This is the incidence on the basis of the vulnerable. The rate is increasing. This is a new peak. Unfortunately the CDC and other Administration entities seem to grossly neglect this effect. The death rate is dropping as we have vaccinated the older and vulnerable but the incidence is climbing as younger and recklessly careless people propagate. The seem to not be aware of the sequellae that they will have to deal with. This is a Public Health disaster.
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