As many of you already know, last Thursday there was a highly coordinated attack on my personal and professional social media accounts, which resulted in a successful hack (yes, I had two-step authorization and yes, my passwords were complex).
Helplessly watching a group take away 11 months of my hard earned blood, sweat, and tears has been one of the most heartbreaking experiences of my life. That is/was a page I started from scratch, which I grew into a following of more than 160,000 people in 11 months with over 500 posts of evidence-based, data driven information. These posts were shared by Republicans and Democrats, conservatives and liberals, scientists and layman, families and neighbors. They infiltrated echo chambers. They became a place of scientific debate and transparency. All of which are greatly missing from social media and something I’m incredibly proud of building. Also, many of those followers became my friends and highly respected colleagues. But, now, all I can do is watch it slowly burn.
If I’ve learned one thing from this experience, it’s the fact that we all rent space from social media without any tenant rights or control. I still don’t have any access to my social media accounts. I don’t know if (or when) I’ll ever get access again. I have received zero communication. If it wasn’t for my girlfriend working at FB headquarters, I would be completely blind.
But it’s time to pull myself together and get back in the game. So, I’m starting this newsletter. If you found my previous posts useful at all, consider signing up here.
Instead of a FB post or IG post, you will receive an email when I post something new. You won’t get advertisements, FB won’t be collecting any of your data, and it will still be easily accessible to you (something science should always be).
NOTE: If you were already receiving emails from me, you need to sign up again. I think (and hope) that this new site will be more user friendly and, like I said before, you won’t have advertisements stuck to my emails anymore.
Time to rebuild this thing. Here we go.
PS Thank you to my husband for handing me this mug filled with coffee this morning, ultimately refueling my fire.
Last night I reported that Texas cases are increasing. We are the only state with an increasing trend right now. I was incredibly curious about this, so I looked into it further…
Cases…are plateauing which is probably explaining the mixed results the past few days. This is NOT the same trend as the rest of the country. We have a state R(T)=0.97. We are decreasing transmission, but barely. And, it looks like we are on the brink of exponentially increasing if we don’t do something about it. Case increases look like they are mainly driven by Trauma Service Area (TSA) H (Lufkin R=1.41); TSA L (Belton/Killeen R=1.39); TSA M (Waco; R=1.48); TSA N (College Station/Bryan R=1.87); TSA O (Austin R= 1.23). TSA J (Midland) is doing the best so far with a R=0.52. Go Midland!
Testing…We define hotspots as a Test Positivity Rate >10% AND more than 100 daily cases per 100,000. 232 counties in Texas (out of 254 counties) are considered hot spots today.
Hospitalizations…are decreasing as a state as a whole. However, there are some areas still doing very poorly. TSA E (DFW), TSA I (El Paso), TSA S (Victoria), and TSA T (Laredo) still have more than 20% of hospitalizations due to COVID19. Laredo has more than 47%!!. The Governor loosens restrictions for areas when this reaches 15% or less. And that’s for overall hospitalizations. ICU rates still look very scary. There isn’t one area in Texas that has below 20% COVID19 cases. The highest is in TSA H (Lufkin) and TSA S (Victoria) with more than 60% of their ICU’s taken up by COVID19.
Stay vigilant, Texas. We do not want this increasing, even more so before the new variants become dominant.
Your national (U.S.) update as of Feb 3 at 8:00PM CST
Cases… continue to plummet. There’s no doubt that the 2020 holiday season caused a surge in cases. Which is consistent with what we saw on Memorial Day and July 4. The impact that human behavior, like the 2020 holiday season, has on human life is really quite fascinating. Anyways, our 7-day average is now the same as it was on November 12. Today, 42 states have a decreasing 7-day average of cases and 8 states are plateauing. Only Texas has an increasing 7-day case rate (11%).
Testing…is continuing to plateau, which isn’t necessarily bad. Especially if cases continue to decrease. Because this means that test positivity rate will be decreasing. Which is fantastic. We want TPR<10% (<5% is ideal) to get a handle on transmission.
Hospitalizations….are tanking too. Hospitalization trends follow case trends, so this makes sense. Hospitalizations in 41 states are decreasing, 9 states are plateauing, and 1 states is increasing (Vermont=15%). This is also fantastic news. But, remember, decreasing is relative. They are decreasing from the highest peak we’ve every experienced. Today, 91,440 people were on hospital beds for COVID19. This is still higher than the peak in April (59,779 hospitalizations) and July (59,718 hospitalizations).
Deaths…are increasing but significantly losing momentum. In other words, we should see our peak here soon (if it wasn’t today or yesterday). 27 states have decreasing deaths, 15 states are plateauing, and 9 states are increasing. The highest increase in deaths is Iowa, closely followed by South Carolina. Today 3,685 souls succumbed to COVID19. In one day. We were predicting 500,000 deaths by mid-February. This may be end of February now. TBD.
Vaccinations…are slowly (but surely) starting to gain speed and exponentially increase. Which is huge. We (the U.S.) are administering 9.71 doses per 100 people. In the last week, an average of 1.34 million doses per day were administered. Alaska leads with 13.4 doses administered per 100 people. This is followed by West Virginia (11 per 100) and New Mexico (10.5 per 100). Idaho, you’re last, with administering 6.0 doses per 100 people. (Texas you’re close to the bottom too, at 7.2 per 100 people).
Variants...are gaining speed.-B.1.1.7 variant: Has popped up in 541 Americans across 33 states (Florida has, by far, the most people followed by CA). -B.1.351 variant: Detected in 3 Americans in 2 states-P.1: Detected in 2 Americans in 1 state
We are, quite literally, in a race: vaccination rate vs. variant transmission rate. Hopefully we win before mid-March hits.
Disclaimer: This was the most challenging post I’ve ever written. Translating the complexity of the messy study design, statistical analyses, and implications was not easy and I recognize that I may lose a few of you. Just know that it was not intended. And, honestly, I was thinking about not posting this. But NYT came out with “breaking news” headlines this morning so I thought it was important to get out. Buckle up…
Yesterday, the Lancet (a highly respected journal) released a preprint from the AstraZeneca trial. The purpose of this study was to evaluate whether delaying the second dose had an impact on efficacy and antibodies. This was done post-hoc (so not intended, but since they had the data they ran the numbers). This paper also reported asymptomatic numbers, which can tell us impact of transmission after vaccination.
Delayed dose results: -A delayed dose does not impact efficacy. In fact, it improves efficacy. Vaccine efficacy after a single dose of vaccine from day 22 to day 90 post vaccination was a combined 76% (59% efficacy at day 22 and 86% efficacy at day 90). -Protection did not wane before a second dose. Antibody levels were maintained during this period with minimal waning by day 90 day -The impact of a delayed dose on efficacy was no different among asymptomatic and symptomatic cases -This study did confirm the importance of the second dose. We can NOT skip our second dose altogether. This boost is important.
Transmission results: -There were 130 cases of asymptomatic infection. -(remember important context: this trial had some people that got the doses that were intended (SD/SD) and some accidentally got a half dose first (LD/SD).) -There was no difference in asymptomatic cases (and thus transmission) among the SD/SD people (41 cases in vaccine group and 42 cases in control group) -There WAS a difference in asymptomatic cases (and thus transmission) among the LD/SD people (16 cases in vaccine group and 31 cases in control group)
Important considerations that I think are largely missed in mainstream media: -Not all vaccines are the same. In fact, they are quite different. This is NOT evidence that we can delay Moderna or Pfizer doses -There were key analyses NOT included in the paper, particularly age. In fact, it looks like they weren’t included in this delayed dose at all (see Figure). It’s not clear whether a delayed dose is generalizable to older adults (55+ years). This is incredibly important to know, as older folks have less neutralizing antibodies. -It’s obvious that the two groups (those that received a delayed booster vs. those that did not have delayed booster) were VERY different in terms of age, sex, and occupation. We also know that those in the LD/SD group were VERY different in terms of age (younger) compared to those in the SD/SD group. We NEED to take this into account (which the study didn’t do) to imply causality. In other words, it’s not clear whether the increase in efficacy or decrease in transmission was actually from the delayed dose, the low dose, or because of demographics. -This study did not report variants. And did not report whether delaying a second dose adds pressure on the virus to mutate even more
Bottom line: (And this is all my humble scientific opinion; take it or leave it) This data is messy. And it’s really hard to parse together the story in an accurate way. It looks like a delayed dose of AZ is “okay”. We aren’t necessarily surprised by this. But, I don’t think this study provides enough data to make sweeping policy changes (like delaying a second dose for the older population).
It also looks like we can remain hopeful that vaccines reduce transmission. But this wasn’t the “ah ha” transmission study I was waiting for. The data leads us to more questions than answers. We can’t really answer how transmission is reduced because this was not a transmission study. We simply do not have enough people in this study to be confident in the numbers.
So, it’s too early for me to call re: transmission. I know that NYT called it, but, as a scientist, I just cannot. Sorry guys, I’m just as disappointed as you. But, I AM still incredibly hopeful and you should be too. This is a reassuring sign that the pandemic will, in fact, end.
PS: I hope other epidemiologists chime in! I had a brief discussion with other epi’s before posting this, but would love to hear other opinions too!
Data Source: https://poseidon01.ssrn.com/delivery.php?ID=908065002113091029031029004116028092034057081068083017073097002123008109020031031080121005029070024024123121020000093004092067107017108057080016040016089012029024061015090120064080002082029044015123030087062015030073022110003024024070082086119004018090106117113094098107072092070005094074082&EXT=pdf&INDEX=TRUE
Apparently an article is circulating: “COVID19 vaccines will destroy our lives”. And, interestingly, it includes a “fact checked” icon at the top indicating it’s been checked by a credible source.
Well, here is a credible source’s rebuttal…
“The COVID-19 vaccine really isn’t a vaccine in the medical definition of a vaccine”. This is false. The medical definition is: Vaccine: A product that stimulates a person’s immune system to produce immunity to a specific disease, protecting the person from that disease. This is exactly what the COVID19 vaccine does. All of them, regardless of the biotechnology.
“Since mRNA normally rapidly degrades” (this is true) “it must be complexed with lipids or polymers” (this is true). “COVID19 vaccines use PEGylated lipid nanoparticles and PEG is known to cause anaphylaxis.” (This is correct, but taken out of context.) PEG has never been used before in an approved vaccine, but it is found in many drugs that have occasionally triggered anaphylaxis. This is particularly true among people who already have high levels of anti-PEG antibodies or experienced severe allergic reactions in the past. Although many types of nanoparticles do have hypersensitivity properties, some newer nanoparticles have been demonstrating ANTI-allergic effects. Controlling the pro and anti-allergic properties of nanoparticles is one of the key elements towards safe use. The U.S. National Institute of Allergy and Infectious Diseases had a meeting mid-December to discuss the COVID19 vaccine allergic reactions and is conducting several studies on it to better understand why people with previous history may have allergic reactions with Pfizer/Moderna COVID19 vaccines. Nonetheless, since this meeting there have been 50 anaphylaxis cases reported for Pfizer (out of 9.943M doses) and 21 reported for Moderna (out of 7.581M doses). This is an anaphylaxis rate of 5 in 1M people (or 0.000503%). This IS higher than the rate of anaphylactic reactions that happen with any other vaccine (1 in 1M people). But, this IS far less than the 70% claimed in the misinformation article. Also (fun fact) PEG is found in toothpaste and shampoo.
“mRNA can signal danger to your immune system and drive inflammatory diseases”. I guess this is correct? Although, it’s missing a few key steps. The mRNA instructs our body to create a spike protein then which our bodies make antibodies to. These antibodies then recognize (and, thus, signals danger) if you ever come in contact with the COVID virus. This signal is a good thing, as your body is prepared to fight the virus. If you don’t have this protective signal, then you get an inflammatory disease which has landed more than 93,536 people in the hospital TODAY. Also, you should know you have mRNA floating in your body every second of every day. If free mRNA causes a danger signal, then we are in a lot of trouble (regardless of a vaccine or not).
“Many commonly reported side effects from the COVID19 gene therapy “vaccines” appear to be caused by brain inflammation”. The writer doesn’t provide any evidence or context behind this claim. They only state it as fact, so I cannot counter it with science. But, no, the vaccine doesn’t cause brain inflammation. We haven’t seen this and more than 98.3 million doses in 62 countries have been administered.
“Anyone with inflammatory disease (…) are at high risk of dying from COVID19 mRNA vaccines”. This is incorrect. No one’s death has been causally linked to the vaccine.
“Genetic alterations may last for life” This is false. There are no genetic alterations. At all. The mRNA cannot physically enter the nucleus (which houses our DNA in our cells). Briefly, in order for a mRNA vaccine to alter someone’s DNA, several events would have to occur… -mRNA would need to enter the cell nucleus, where DNA lives. However, mRNA do not have the “secret door code” (called nuclear access signal) that would allow it to enter. mRNA vaccines can’t get in. -If the mRNA vaccine did get in (which it won’t), mRNA would have to be then converted to DNA. This would require a tool called “reverse transcriptase”, which the vaccine doesn’t have. -Also, if it made it into the nucleus, mRNA would then to need to insert itself into the DNA. The mRNA would need a tool called “integrase” to do this, which the vaccine doesn’t have.
Bottom line: I get that we are hesitant. This is the most vaccine hesitancy we’ve ever had; you’re not alone. It’s a trust jump. But it’s a trust jump into decades worth of research and scientists with no ulterior motives other than to save lives and improve the quality of life of our community (and maybe get tenure :)). Please make your decision using an evidence-based, data-driven approach.
Data Sources: I would like to thank those Nerdy Girls at Dear Pandemic for encouraging me to write this and ensuring me that it wouldn’t fall on deaf ears. Also, for one of them sacrificing her email address so we could actually read the misinformation being passed around (that’s behind a paywall).
This peer-reviewed scientific article talked about PEG: https://www.sciencedirect.com/science/article/abs/pii/S0378517320307778 This one too: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849378/ And this one too: https://www.sciencemag.org/news/2020/12/suspicions-grow-nanoparticles-pfizer-s-covid-19-vaccine-trigger-rare-allergic-reactions Vaccine tracker: https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ Anaphylaxis rate: https://www.cdc.gov/vaccines/acip/meetings/slides-2021-1-27-21.html About the author behind this misinformation: https://www.washingtonpost.com/investigations/2019/10/15/fdc01078-c29c-11e9-b5e4-54aa56d5b7ce_story.html Pfizer safety data: https://www.fda.gov/media/144245/download Moderna safety data: https://www.fda.gov/media/144434/download Long-term effects of the vaccine: https://yourlocalepidemiologist.com/long-term-effects-of-the-covid19-vaccine/ The vaccine got to us incredibly fast: https://yourlocalepidemiologist.com/the-vaccine-got-to-us-incredibly-fast/ mRNA and our DNA: https://yourlocalepidemiologist.com/mrna-and-dna/ Deaths and the vaccine: https://yourlocalepidemiologist.com/deaths-and-the-vaccine/
We are seeing more and more evidence that moms pass COVID19 antibodies to their babies…
There have been 3 important studies that have recently come out telling the same story…
Between April and August 2020, scientists tested 1,500 women who gave birth in Philadelphia. They found… -83 had COVID antibodies -Among the 83, 87% of their babies tested positive for IgG antibodies (the long lasting antibodies) after they were born -Transferring antibodies was not different among infants born to mothers with asymptomatic or symptomatic illness -In 25% of the babies, their antibody levels were 1.5 to 2 times higher than the mother’s concentration -The longer the time period between the start of a pregnant woman’s COVID infection and her delivery, the more antibodies were transferred to the baby
From April 4 to July 3, 2020, in a single university hospital in Denmark, 1,313 women took part in a study. -28 women (2.1%) had antibodies against COVID -67% of newborns delivered by mothers with antibodies had COVID IgG antibodies. -Neonatal outcomes (like birth weight, APGAR value, amniotic fluid, CPAP, and blood pH) were not affected by the antibody status of the mother
Another study enrolled 22 COVID+ moms and 34 COVID- negative moms and tested their cord blood after birth. -Antibody transfer was efficient after second-trimester infection -While antibodies do pass, they do less efficiently than the antibodies produced after vaccination for flu and whooping cough. But this effect was only observed in third-trimester infection.
Like always, we still have a lot of unanswered questions. We need more research to better understand two things:
Do vaccine-generated antibodies behave comparably to antibodies from COVID infection?
Are antibodies protective against newborn infection? If so, at what concentration?
Bottom line: We already know there are benefits to pregnant women getting vaccinated. These studies suggest that there also may be benefits to the baby. Interestingly, timing of infection (or possibly timing of vaccination) may be important to ensure baby getting antibodies.
Unfortunately, pregnant women were excluded from clinical trials (which has stirred quite the debate among scientists), so these questions will take quite a bit of time to answer.
Data Sources: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2775945 https://journals.lww.com/greenjournal/Fulltext/2021/01000/Severe_Acute_Respiratory_Syndrome_Coronavirus_2.7.aspx https://www.cell.com/cell/fulltext/S0092-8674(20)31749-9