News for January 4 — Vaccine Delivery Strategy; Haven Folds

Vaccine delivery strategy: https://www.reuters.com/article/us-health-coronavirus-usa-moderna/u-s-may-cut-some-moderna-vaccine-doses-in-half-to-speed-rollout-official-says-idUSKBN2980NW . The Moderna data that is public so far was half vaccine dose – full vaccine dose, and involved a small sample size. Right now our problem is not vaccine doses, it’s completing vaccinations.

US plans to stick with full two-dose vaccine delivery strategy: https://www.msn.com/en-us/news/us/us-health-officials-say-they-plan-to-stick-with-two-dose-coronavirus-regimen/ar-BB1ct6FM?li=BBnb7Kz . This is an interesting argument, and both sides have valid points. As noted above, we have to deliver the vaccines we have effectively before alternate dosing strategies could become a reality.

However, I have heard that there is data that persons develop about 90% immunity after receiving the first dose, which increases to 95% after the second dose. If that’s accurate, as a disease management matter it makes sense to follow the one-dose strategy for persons ages 18 to 55. The second dose takes a new patient from 0% to 90% rather than an existing patient from 90% to 95%. The 85% gain is important in driving down R0 (the retransmission rate) as quickly as possible.

I have also heard that the drug store chains have the capacity to deliver a combined 100 million doses per month. The optimal plan would move vaccine distribution to the drug stores and deliver as many first doses as possible. We would complete the two-dose regimen ASAP for the over-55 population, which has sustained 95% of the deaths.

No vaccine delivery strategy is without risk. However, what I’m suggesting is the best approach given available information. It does require thinking outside the box, which is always a problem for government.

Patient care strategy: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-model-of-care-and-research-leads-to-favorable-outcomes-for-patients-with-covid-19/ . Mayo Clinic reports that their care model has had better than average outcomes for the patients in their care.

WSJ: COVID long-hauler experiences: https://www.wsj.com/articles/no-one-else-is-listening-readers-share-experiences-with-long-haul-covid-11609772400 .

Veteran deaths: https://www.militarytimes.com/news/pentagon-congress/2021/01/04/vas-coronavirus-deaths-have-now-surpassed-totals-from-iraq-afghanistan-wars/ .

WSJ: Vaccine worker shortage: https://www.wsj.com/articles/covid-19-vaccines-are-in-high-demand-but-thousands-more-workers-are-needed-to-make-them-11609764172 .

WSJ: Prison vaccinations: https://www.wsj.com/articles/as-covid-19-surges-in-jails-guards-want-vaccine-early-11609768624 .

Will vaccines protect against South African variant?: https://www.reuters.com/article/us-health-coronavirus-britain-south-afri/uk-scientists-worry-vaccines-may-not-protect-against-s-african-coronavirus-variant-idUSKBN2990T3 . As this is being tested, we should learn soon enough. It’s great that the existing vaccines can be tweaked to address the variant. That is a notable advantage of the mRNA approach. However, there is a safety question as to whether the tweak should be approved without a Phase 3 trial. Such a trial would add a couple of months to the roll-out process. More: https://www.politico.eu/article/the-south-african-covid-19-variant-what-we-know-so-far/ . The US exposes Americans and the world to serious risk by our lack of genomic sequencing analysis.

Mexico approves AstraZeneca vaccine: https://apnews.com/article/health-coronavirus-pandemic-mexico-fc06d8d29aa28093488ccd6a40997d7d .

Major airlines back global traveler testing in place of blanket travel restrictions: https://www.reuters.com/article/us-health-coronavirus-airlines-testing-idUSKBN29929H . This is understandable from the airlines’ business interests. However, testing is not as effective as restricting travel from a public health standpoint.

Cuomo wants vaccine fraud criminalized: https://www.usnews.com/news/health-news/articles/2021-01-04/cuomo-to-propose-law-criminalizing-coronavirus-vaccine-fraud . Sad but sorely needed. WSJ: Cuomo acts to accelerate vaccinations: https://www.wsj.com/articles/new-york-nurse-gets-second-dose-of-covid-19-vaccine-11609792513 .

Joint healthcare venture Haven to fold: https://www.cnbc.com/2021/01/04/haven-the-amazon-berkshire-jpmorgan-venture-to-disrupt-healthcare-is-disbanding-after-3-years.html . More details would be of interest. Amazon has 1.3 million employees, so they are able to do whatever they want. Berkshire Hathaway and JP Morgan also have hundreds of thousands of employees. Apparently they concluded that the added scale didn’t justify giving up control of their own programs. WSJ: More: https://www.wsj.com/articles/amazon-berkshire-hathaway-jpmorgan-end-health-care-venture-haven-11609784367 .

Grapefruit  and drug interactions: https://www.atlasobscura.com/articles/grapefruit-history-and-drug-interactions . You probably know that eating grapefruit can affect drug absorption. This article, about halfway in, explains the mechanism in detail.

WSJ: South Korea’s population falls: https://www.wsj.com/articles/south-koreas-population-falls-for-first-time-likely-worsened-by-covid-19-11609767528 . Simple enough: there are more deaths than births. This is not an emigration issue. The population is rapidly aging.

Poll: 75% of Americans say $600 check is too little: https://thehill.com/hilltv/what-americas-thinking/532566-poll-75-percent-of-voters-say-600-coronavirus-relief-checks-are .

Wisconsin vaccine destroyer a conspiracy theorist: https://www.nbcnews.com/news/us-news/wisconsin-pharmacist-who-tried-destroy-covid-vaccine-conspiracy-theorist-authorities-n1252770 .

The rule of law takes another run at Nut World: https://www.usatoday.com/story/news/politics/2021/01/04/live-politics-updates-monday-donald-trump-joe-biden/4124328001/ . The USA Today coverage is provided here because it includes comments from David Perdue. His reaction is to attack the Georgia Secretary of State for recording the call! We will see multiple books and disclosures about the Trump White House in 2021, and many will feature documentary evidence. After 4 years of this, you’d have to be brain dead not to document your dealings with Orange Julius.

What we are seeing here is a skirmish in the larger battle within the Republican Party. Do Republican politicians stick with Trump’s domination of the base, or do they return to reality? The final result will be a mixture of both. The base is now so filled with conspiracy theories that telling the truth is not an option for many Republican politicians. Otherwise, they’ll get a primary challenge. For House Republicans, the primaries are 18 months away. And that is all they think about. Not decency, not honesty, not the country.

Judge tosses election lawsuit, indicates he is considering disciplinary referral against plaintiff’s lawyers: https://www.cnn.com/2021/01/04/politics/discipline-election-lawsuit-republicans/index.html . I TOTALLY AGREE that disciplinary referral is appropriate. The court has a responsibility to maintain the rule of law from political weaponization.

WSJ: Closing arguments in Georgia runoff: https://www.wsj.com/articles/georgia-girds-for-senate-runoffs-in-wake-of-trump-call-11609785914 . As far as I know, the Tuesday in-person vote will be counted first. Then, regardless of who wins, the Republicans will again take the early lead. So be prepared for more claims of fraud. This is just sickening. I’m regarding this as the last event of 2020.

Reports of Tanya Roberts’ death premature: https://people.com/movies/tanya-roberts-is-alive-despite-husband-and-rep-announcing-death/ . However, she remains hospitalized and apparently quite ill.