Since my last article, published in December, regarding COVID-19, the Pfizer and Moderna vaccines are now being administered nationally. In Sullivan and surrounding counties, our local first responders, medical and nursing home personnel, along with high-risk residents, are now beginning to receive COVID-19 immunizations.
It is chilling to see that the previously projected numbers of reported cases, hospitalizations and deaths are, unfortunately, right on track. We have reached 400,000 deaths nationwide by mid-January and will approach 500,000 cases before the end of February, assuming that the number of deaths continues to average 3,000 to 3,500+ daily. This growth of new cases will continue until there are adequate levels of immunization locally and nationally.
Additionally, there is a decreasing number of ICU and special care units in many communities, and for some locals, there are no beds available for any medical reason. This is particularly true in Los Angeles, CA where EMTs are instructed not to transport anyone who appears close to death, and some hospitals are triaging patients before they come into a hospital. There is also a shortage of oxygen supplies for many of these hospitals. Hopefully, we will soon be seeing a drop in hospitalizations in these overburdened locations.
It is disappointing that distribution of the two available vaccines has been slower than expected, with only about 12 million doses being given as of mid-January—far behind the projected 20 million by the first of January. This should improve with the introduction of new distribution systems and the introduction of other vaccines.
The COVID-19 vaccine by Johnson & Johnson has the distinct advantage that it is a single dose, less expensive and easier to store. It appears that it will be coming up for emergency approval sometime in the next several weeks. This vaccine is similar to the AstraZeneca’s product, as it was made from a weakened version of a common cold virus (adenovirus). The difference between these vaccines and the Pfizer and Moderna vaccine is that, instead of using only messenger RNA, Johnson & Johnson and AstraZeneca vaccines use adenovirus and DNA coded for the spike protein.
The adenoviruses enter human cells and travel into their nuclei (the chamber where the cell’s DNA is stored). The vaccine is programmed to carry the genetic DNA that’s coded for making spike protein. The modified DNA then produces mRNA and this, in turn, programs the cell to produce spike proteins. This protein eventually migrates to the surface of the immunized cell. Immune cells (T and B cells) recognize the invading spike protein, stimulating them to attack the spike protein-infected cells and produce antibodies.
This tricks the body into mounting an immune response to attack coronavirus if the real virus infects the body. Again, the modified adenovirus can enter cells but can’t replicate inside them or cause illness. Researchers have already used this technology to produce vaccines against a number of pathogens including flu, Zika and Middle East respiratory syndrome (MERS).
The Oxford-AstraZeneca vaccine requires two doses given four weeks apart. Effectiveness is being studied and approval is coming up.
The question of when each of us can arrange for vaccination is controlled by the state where you live and not by your county health departments. It is arranged this way so that people who are at the highest risk—such as health professionals, nursing home employees and residents of these facilities—receive their vaccines first and discouraging people from jumping the line.
There has been a change in the priority groups by combining groups, including first responders, teachers/school staff and essential frontline workers who interact with the public (e.g. pharmacists, child care providers, grocery store employees). Also included are people in the general public with high-risk health conditions regardless of age, and people older than 65.
The goal of the Biden administration is eventually to expand the program to have a million vaccinations per day nationwide.
As of January 20, the dates and locations of vaccine centers and commercial providers have yet to be announced for these groups. Sullivan County residents can click here for the most up-to-date information.
For the upcoming weeks, there will be modifications to this system depending on the availability of vaccines and physical locations, along with finding adequate numbers of persons to administer these vaccines. Scheduling systems are now beginning to be set up. We will all have to be patient. Additionally, we cannot let down our guard. There is no longer any excuse for people not to mask up in public, space themselves six feet apart, avoid being in crowded places or mixing households.