These vaccines have been granted extraordinary privilege: Sales of hundreds of millions of doses already without full approval. Under EUA. Billions more need them in the world.
It's the type of situation where big governments have to help fix reasonable prices.
Governments with leverage over these companies should not hesitate to use it make these vaccines affordable. So countries don't ruin their healthcare systems by spending all they have on these vaccines to save their citizens. So we can save as many lives as possible.
Note that any boosters that are made to improve durability of protection or to counter COVID variants take on much less risk than the initial product where we had no idea of safety or efficacy. Plus they are all guaranteed sales of the same magnitude as the current vaccines.
I recognize the immense significance of these vaccines, and I am grateful we have them. I called them one of the greatest advances in medicine of all time. I also recognize when their price should be much lower.
The 4 COVID variants considered variants of concern by the WHO.
Of these, B.1.617 worries me the most. This is the variant that is sweeping across India. It appears more contagious, and likely more virulent. who.int/docs/default-s…
There are 3 subtypes of this variants. B.1.617.1, B1.617.2, and B1.617.3.
Preliminary studies suggest it is more contagious. Although the vaccine induced neutralizing antibody activity appears lower, it is still more than enough to neutralize the virus. google.com/amp/s/www.cnbc…
This drop in confirmed COVID cases in India is an illusion. First, due to limited testing, the total number of cases is a huge underestimate. Second, confirmed cases can only occur where you can confirm: the urban areas. Rural areas are not getting counted. @BDUTT
The daily confirmed deaths in India had exceeded 4000. At no time in the pandemic did any country exceed 3500.
The 4000 deaths are also a huge underestimate. Last year deaths were probably undercounted by a factor of 2 or 3. Now probably 10.
Although a nationwide lockdown would have been ideal, this has not happened. However most states have instituted lockdowns. This is less that ideal (since strictness varies a lot) but will help bring true cases and deaths come down in 2 weeks.
Lymphomas, myeloma, CLL are cancers of the immune system itself. The chemotherapy we use in these cancers are aimed at the very cells that help us fight infection.
The best recommendation I have is consider monoclonal antibody cocktails early, as soon as COVID is diagnosed.
We don't routinely check antibody levels after vaccination. It's like low in patients with lymphoma, myeloma, and CLL after vaccination. But patients should know that antibodies are just one part of the picture. They will likely still be protected from severe disease.
Even though CDC has said masks are not needed for fully vaccinated people, till we get more information on vaccine efficacy, patients with lymphoma, myeloma, & CLL on chemotherapy should probably continue to wear a mask indoors when people who don't live with you are around you.
A lot of COVID deaths in India in young people who should be doing well & recovering.
I am making a plea to doctors in India to cut down the use of STEROIDS. Please.
Steroids are only useful after the patient is hypoxic. Harmful if given early, or given for too long
In the first week of the illness when the virus is dividing, the use of steroids can suppress the immune response and make the virus divide even more. Steroids are not antivirals. There was a trend to more deaths in RECOVERY trial in patients who were not hypoxic.
In patients who have hypoxia, it signals that there is lung involvement. By now the virus is likely controlled by the body and the damage is from the immune system. Only at this stage are steroids useful: at small dose (Dex 6 mg) and short duration (5 days).
What you missed from the WH briefing yesterday: Dr. Fauci's comments. @ASlavitt
1/ We are going to keep having mutants/variants and one of the solutions would be to have a pan corona virus vaccine that stops the virus no matter what it does.
2/ Dr. Fauci referred to an important paper published in @nature on an exciting new nanoparticle cross neutralizing antibody technology targeting both pandemic and pre-emergent coronaviruses. nature.com/articles/s4158…
3/ The idea is to make a vaccine that elicits antibodies that can neutralize multiple different coronaviruses: A pan-coronavirus vaccine. And that it might be possible! Coming from Dr. Fauci who led the NIH team that developed the Moderna vaccine, I am taking notice.
The WHO updated its guidance on June 5, 2020, agreeing that masks are recommended for all people in areas with high transmission— not just people with respiratory symptoms.