60th Update on Corona Virus Pandemic with Dr Peter (next update March 15)

2/22/2021

Help in Covid Research Study

Symptom Tracker App that enables you to participate in a study. Developed by UK universities and New England Journal of Medicine. Being used to predict where new cases may appear and what side effects people are having, symptoms and relationship to underlying health conditions.

C-19 Symptom Study made by Zoe Global Limited (FREE download)

Designed to be used by anyone – whether you are well or having any symptoms. List symptoms daily and you can record when you have your vaccine doses and side effects.

Vaccines and Availability

Moderna and Pfizer vaccines – first available. Moderna is about $40 per dose and Pfizer about $20 per dose. All other vaccines are about $5 per dose. This is hopeful to use as a planetary solution

Johnson and Johnson vaccine:

This is on one shot vaccine based on an adenovirus. Not sure when it will be available. About $3 per dose.

Novovax Vaccine:

Not sure if this is one or two dose. Synthetic protein. About $3 per dose. Not approved yet.

Astrazeneca Vaccine:

Not sure when it will be available here. This is a two shot series. It is being given widely in the UK and throughout the world. Also based on an adenovirus.

Russian Vaccine – Sputnik:

$3 per dose. Two shots. Adenovirus basis. Each shot is based on a different virus to give a broader immunity and the two shots are given 3 months apart. Giving a single dose that gives most of the immunity and then a booster later (like 3 months) would allow us to give more people shots faster.

Currently, we are vaccinating 65yo and older and also those in essential work force.

In Oregon: Oregon Health Authority Vaccine information

Why are we vaccinating?

Main reason is to slow the transmission (R0) With even a single dose of M or P vaccine, there is at least a 70% decrease in transmissability. Could be more than that. More than protection and reducing serious illness and hospitalization.

When people get vaccinated, we also reduce the number of mutations. When people get infected with the virus, mutations happen. Most are nonviable or don’t spread. But when there is an active form of a mutation, it can change the transmission rate. It’s also possible to get infected with two versions of the virus, creating a recombinant virus. This happened in California. This “California strain” may not spread much, but it can happen. The dominant strain will be the B117 mutation by the end of March.

With vaccinations, we will reduce hospitalizations and serious symptoms and with lower viral loads there will be fewer “long haul” symptoms, also fewer people in quarantine who miss work. Reopening economy and schools will be possible. Vaccine “passports” will be possible for travel.

Most people do well with minor symptoms after first vaccination and the second dose often has stronger response, particularly with under age 55. This is good – for the immune system to give a strong response. Women often have a stronger immune response than men. Fatigue, fever and headache, muscle aches are common. If people have had Covid19 previously, they have a stronger response, even with the first shot.

Plan on taking it easy and get out of big commitments during that 3-5 days after vaccination.

It is helpful in the 24 hours before vaccination and 3-5 days after, to avoid anti-inflammatory medication and allow the immune system to act.

B117 and B1351

B117 is the dominant strain in US and B1351 is in South Africa. These are more transmissable and the vaccine is not quite as effective with B1351. The vaccine we are using is working effectively against the B117 strain.

South Africa and Zambia are having difficulties with the B1351 strain. 1 in 5 adults is HIV positive and the Covid virus is very hard on them.

Case Counts

Right now the case counts are going down. CDC and other agencies are concerned that counts may go up in mid-March and peaking in April and going down in May. This is an estimate and not sure.

There are 60 – 70,000 new cases per day now which is much better. The concern is that the B117 strain will dominate and cause more cases peaking in April, with perhaps 200K cases per day. Not as high as there has been, but higher than now.

But the thought is the death rate will not be as high. Why? – A lot of the high risk groups that would be hospitalized and at greater risk of death will be vaccinated by then. We are also doing better with treatments.

Economy is still highly impacted. The economic impact is often the last to recover after a crisis.

Why are case rates going down now?

Some theories have said we are nearing herd immunity with the vaccines and the case counts will continue to go down.

UK has had a very difficult time with the B117 strain and we haven’t had to deal with B117 yet. Many different factors are affecting the case count and a really complex problem is not solved with one simple solution. Mutations, vaccines, behavior, unknown factors, and many things make it difficult to predict where we will be two months from now.

Testing

How we count cases also affects the case count. PCR testing done at big labs are the only cases being counted right now. Rapid antigen tests do not get reported and the home tests do not get reported.

They have decreased the cycle times on the PCR test and some cases that are no longer infectious may not be caught, which may affect the numbers a bit, but not in large amounts.

What happens may be somewhere in the middle of two extremes being predicted. Still a significant process happening in the US. Have hit 500,000 deaths and will most likely have 600,000 by June.

Public Health Update:

Probably given 10,000 people at least one dose of vaccine.

Many in Nevada County have traveled out of the county to get vaccine. By April-May there will most likely be enough vaccine for everyone who wants one.

Skilled nursing facilities are 100% vaccinated now in NC. This is very good news.

Local radiation oncology group is part of a trial treating Covid patients who have serious lung inflammation with radiation.

Tahoe Forest Hospital (Truckee CA) was able to very aggressively vaccinate seniors in their area and their staff and the number of hospitalizations has decreased to 0. No hospitalizations in 14 days.

This is hopeful for the rest of the country as we get vaccines out.

Statistics (3 weeks since the last update)

Nevada County (about 100k pop)

3850 cases, up about 300 cases from 3 weeks ago.

Case Positivity Rate: An average daily positivity rate (over 14 days): 8.5% down from 13.6%

6-8 people hospitalized for COVID 19. ICU cases 1, down from average of 3.

Deaths in county: 74, same.Case Fatality rate: 2%

450cases, up from 400, in the 95959 zip code, where Ananda Village is located.

Sierra County (3100 pop)

Just a few new cases.

Case positivity rate averaged over 14 days is 5%, down from10%

Yuba County (80Kpop)

5700 cases, up from 5400Hospitalized: 14, down from 51

CPR: Averaged over 14 days is 7.9%, down from 14.3%

Deaths: 36, up from 31

Placer County (400Kpop)

120Kcases, up 1100 from2 wks ago

CPR: 14 day average is 4.8%, down from 9.3% 3 wks ago

Hospitalized: 38, down from 137 Deaths: 230

California:

3.5 million cases, up from 3.3 3wks ago

CPR: 3.5%, down from 7.4%

Hospitalizations: 7300 – half of what it was 3 wks ago
ICU: 2100 – down by half

49,000 deaths. Deaths will continue to go up, from the 1.6 million cases that are still active

US (330 mill pop)

28.7 million cases, up 2 million from 3 wks ago

Cases per day: about 60 – 70 K, down from 150K

Deaths: 2000 per day, which is down from 3000- 3500 per day

Jyotish and Devi:

Have talked with India where things are going back to normal. Case counts very low.

End