Just Another SARS-CoV-2 Vaccine Chart – Updated 02.11.21

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Doctors keep making cool graphics. I keep finding them. Note Column six from the left in yellow has been updated.

Vaccine table produced by Monica Gandhi MD MPH. Downloaded from Twitter 02.11.21

Monica Gandhi MD, MPH is Professor of Medicine and Associate Division Chief (Clinical Operations/ Education) of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital. She also serves as the Director of the UCSF Center for AIDS Research (CFAR) and the Medical director of the HIV Clinic at SFGH (“Ward 86”). Dr. Gandhi completed her M.D. at Harvard Medical School and then came to UCSF in 1996 for residency training in Internal Medicine. After her residency, Dr. Gandhi completed a fellowship in Infectious Diseases and a postdoctoral fellowship at the Center for AIDS Prevention Studies, both at UCSF. She also obtained a Masters in Public Health from Berkeley in 2001 with a focus on Epidemiology and Biostatistics.

https://profiles.ucsf.edu/monica.gandhi

Covid-19: How close is the light at the end of the tunnel? — Tim Harford

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Will it ever end? In November, we were celebrating the announcement that the BioNTech/Pfizer vaccine seemed to be highly effective against Covid-19, followed with bewildering speed by similar claims for the Sputnik V, Moderna and Oxford/AstraZeneca vaccines. Nearly three months later, hospitals are overwhelmed and the global death toll is climbing twice as fast as…

Covid-19: How close is the light at the end of the tunnel? — Tim Harford

Necessity of 2 Doses of the Pfizer and Moderna COVID-19 Vaccines – JAMA

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The Centers for Disease Control and Prevention (CDC) recommends that the second dose of the COVID-19 vaccine be given within 3 weeks of the first dose for the Pfizer vaccine and within 4 weeks for the Moderna vaccine. No more than 6 weeks should lapse between doses, although if the second dose is not given during these time frames, it can be given without the need to repeat the first dose. It is not recommended to give the second dose any earlier than stated above, but if a person needs to get the second dose earlier, giving the second dose up to 4 days ahead of schedule is allowed.

Necessity of 2 Doses of the Pfizer and Moderna COVID-19 Vaccines — https://jamanetwork.com/journals/jama/fullarticle/2776229

Another Reason to GET VACCINATED

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Since the early onset of the coronavirus pandemic, the loss or distortion of smell and taste have emerged as one of the telltale symptoms of COVID-19, with an estimated 86 percent of mild cases displaying signs of olfactory dysfunction. In many cases, patients cannot perceive smells (known as anosmia) — and with it the nuances of flavor inextricable from aroma — or any kind of taste (ageusia). In others, the dysfunction eventually manifests as warped senses of smell and taste (parosmia and parageusia, respectively), rendering previously familiar scents and flavors rancid, like being assaulted with the overwhelming stench of rot, feces, and chemicals.

We Asked People Who Lost Their Taste to COVID: What Do You Eat in a Day? — https://www.eater.com/2021/2/5/22267667/covid-19-loss-distorted-taste-smell-anosmia-parosmia-symptom-food-diaries

Interesting set of short interviews with some long haul Covid-19 sufferers. Think about it. What do you eat when everything tastes like crap?

E. coli Outbreak with Unknown Food Source – CDC

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As of February 1, 2021, a total of 16 people infected with the outbreak strain have been reported from 5 states. This map shows where sick people live.

Illnesses started on dates ranging from December 23, 2020, to January 7, 2021. This chart shows when people got sick. Recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to link illnesses to an outbreak.

Sick people range in age from 10 to 95 years, with a median age of 31, and 88% are female. Of 12 people with information available, 9 have been hospitalized. Of 11 people with information, 3 developed a type of kidney failure called hemolytic uremic syndrome (HUS). One death has been reported from Washington.

Investigation Details — https://www.cdc.gov/ecoli/2021/o157h7-02-21/details.html

“Unknown food source” bothers me.

Just Another SARS-CoV-2 Vaccine Chart

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Doctors keep making cool graphics. I keep finding them. Note Column six from the left in yellow.

Vaccine table produced by Monica Gandhi MD MPH. Downloaded from Twitter 02.03.21

Monica Gandhi MD, MPH is Professor of Medicine and Associate Division Chief (Clinical Operations/ Education) of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital. She also serves as the Director of the UCSF Center for AIDS Research (CFAR) and the Medical director of the HIV Clinic at SFGH (“Ward 86”). Dr. Gandhi completed her M.D. at Harvard Medical School and then came to UCSF in 1996 for residency training in Internal Medicine. After her residency, Dr. Gandhi completed a fellowship in Infectious Diseases and a postdoctoral fellowship at the Center for AIDS Prevention Studies, both at UCSF. She also obtained a Masters in Public Health from Berkeley in 2001 with a focus on Epidemiology and Biostatistics.

https://profiles.ucsf.edu/monica.gandhi

Love the Zeroes

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Downloaded from Twitter 02.01.21. Chart created by Dr. Jha

Ashish K. Jha, MD, MPH, is a physician, health policy researcher, and the third Dean of the Brown University School of Public Health. Before joining Brown, he was the K.T. Li Professor of Global Health at the Harvard T.H. Chan School of Public Health and Director of the Harvard Global Health Institute (HGHI).

https://www.brown.edu/academics/public-health/about/people/dean/ashish-jha

Diabetes and Covid-19

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Catching up on diabetes and found several interesting studies.

CONCLUSIONS: Diabetes status, both type 1 and type 2, independently increases the adverse impacts of COVID-19. Potentially modifiable factors (e.g., HbA1c) had significant but modest impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in this community.

COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes — http://Diabetes Care 2021 Feb; 44(2): 526-532. https://doi.org/10.2337/dc20-2260

CONCLUSIONS: Social vulnerability contributes considerably to the probability of hospitalization among individuals with COVID-19 and diabetes with associated comorbidities. These findings can inform mitigation strategies for populations at the highest risk of severe COVID-19.

Incremental Risk of Developing Severe COVID-19 Among Mexican Patients With Diabetes Attributed to Social and Health Care Access Disadvantages — http://Diabetes Care 2021 Feb; 44(2): 373-380. https://doi.org/10.2337/dc20-2192

This study shows that diabetes is associated with a greater risk of fatal COVID-19, influenza/pneumonia, and CHD in both sexes. However, unlike for CHD, there are no sex differences in the association between diabetes and death from COVID-19 or influenza/pneumonia. Our finding that diabetes is associated with higher risk of COVID-19 mortality is consistent with other studies (1–4). A study of 61 million individuals in England showed that over a third of all in-hospital COVID-19–related deaths occurred in those with diabetes, and those with diabetes had higher odds of in-hospital COVID-19–related death than those without diabetes (1). In contrast to our study, however, that study suggested that women with diabetes were at higher risk of COVID-19–related mortality than men (1). Our results suggest that worse glycemic control might further increase risk of COVID-19 mortality among those with diabetes. Some studies have also reported that individuals with undiagnosed diabetes are particularly at increased risk of severe COVID-19 infections (3,4). Although relatively few participants had undiagnosed diabetes in the current study, we showed that undiagnosed diabetes was associated with a 3.5-fold excess risk of COVID-19 mortality in men. Although there were no sex differences in the association between HbA1c levels and COVID-19 mortality, the finding that associations are broadly similar across sexes and diseases with the exception of women with CHD is interesting, and it is important when considering mechanistic explanations of the female disadvantage in CHD. Overall, these findings indicate that strategies to prevent diabetes, to promptly identify individuals with diabetes, and to improve glycemic control among those with diabetes could lead to better COVID-19 outcomes for both sexes.

Diabetes and COVID-19–Related Mortality in Women and Men in the UK Biobank: Comparisons With Influenza/Pneumonia and Coronary Heart Disease — http://Diabetes Care 2021 Feb; 44(2): e22-e24. https://doi.org/10.2337/dc20-2378

Take home lesson: don’t develop diabetes.

Does Vitamin D Deficiency Raise COVID-19 Risk? – JAMA

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Despite Fauci’s recommendation and claims by many supplement sellers, conclusions about vitamin D blood levels’ connection to a host of diseases, including infections, cannot be determined because of mixed or sparse evidence, according to a recent report written for the US Preventive Services Task Force, which is updating its recommendation on vitamin D deficiency screening. The draft updated recommendation, like its 2014 predecessor, concludes that the evidence is insufficient to assess the benefits and harms of screening in asymptomatic adults for any reason.

Sorting Out Whether Vitamin D Deficiency Raises COVID-19 Risk — https://jamanetwork.com/journals/jama/fullarticle/2775003

The comments to this JAMA article are as educational as the article itself.

But as the debate rages on, I’ll continue to take 1000iu D3 daily. It can’t hurt.