With so many people getting infected recently, some folks may wonder what’s the point of getting vaccinated at all?
And is there really any value to a booster dose if I’ve had two Pfizer/Moderna or a shot of J&J?
My observations: 🧵
Every patient I’ve seen with Covid that’s had a 3rd ‘booster’ dose has had mild symptoms.
By mild I mean mostly sore throat. Lots of sore throat. Also some fatigue, maybe some muscle pain.
No difficulty breathing. No shortness of breath.
All a little uncomfortable, but fine.
Most patients I’ve seen that had 2 doses of Pfizer/Moderna still had ‘mild’ symptoms, but more than those who had received a third dose.
More fatigued. More fever. More coughing. A little more miserable overall.
But no shortness of breath. No difficulty breathing.
Mostly fine.
Most patients I’ve seen that had one dose of J&J and had Covid were worse overall. Felt horrible. Fever for a few days (or more).
Weak, tired. Some shortness of breath and cough.
But not one needing hospitalization. Not one needing oxygen.
Not great. But not life-threatening.
And almost every single patient that I’ve taken care of that needed to be admitted for Covid has been unvaccinated.
Every one with profound shortness of breath. Every one whose oxygen dropped when they walked. Every one needing oxygen to breath regularly.
The point is you’re gonna hear about a LOT of people getting Covid in the coming days and weeks.
Those that have been vaccinated and got a booster dose will mostly fare well with minimal symptoms.
Those getting two doses might have a few more symptoms, but should still do well.
Those who got a single J&J similarly may have more symptoms, but have more protection than the unvaccinated (if you got a single dose of J&J, please get another vaccine dose—preferably Pfizer or Moderna—ASAP!)
But as I’ve witnessed in the ER, the greatest burden still falls on…
The unvaccinated. Those who haven’t gotten a single dose of vaccine.
They’re the most likely to need oxygen. They’re the most likely to have complications. They’re the most likely to get admitted. And the most likely to stay in the hospital for days or longer with severe Covid.
These are all just observations from my recent shifts in the ER.
But the same has been borne out by local and national data showing that the unvaccinated make up a very disproportionate share of those with severe disease, needing hospitalization, and dying from Covid.
So no matter your political affiliation, or thoughts on masks, or where you live in this country, as an ER doctor you’d trust with your life if you rolled into my emergency room at 3am, I promise you that you’d rather face the oncoming Omicron wave vaccinated.
Please be safe. ❤️
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I've spent a lot of the last week speaking to people across government, media, and other actors involved in the Ebola response. Some reflections:
Size of the outbreak: this is massive already. Based on some other signals and conversations, this outbreak is at least 2-3 months old.
Official case numbers are ~1,000. But I suspect the true number is much larger, probably double. This will almost certainly end up being the second largest Ebola outbreak ever, and soon.
There have been 'mysterious' outbreaks close to the current hotspots for some time, and we still don't have a full accounting of all those.
I worked as an epidemiologist during an Ebola outbreak in Guinea in 2015. Tracking this and contract tracing is tough work. It'll take a few more weeks to further understand what communities have already been affected.
Vaccines/Treatments: you've probably heard there are "no treatments of vaccines" for the Bundibugyo species of Ebola.
There's been some movement on moving candidates along—including from Oxford to use the ChAdOx platform for a potential vaccine. Work on that is progressing, but would be many months away.
There's also a rVSVΔG vaccine—using the same platform as the FDA-approved Merck vaccine for Zaire Ebolavirus—that's being discussed, but would also take many months.
We have LOTS of Ervebo, that FDA-approved vaccine for the Zaire species, and there is some discussion about potentially using it here, since it *may* offer some cross-protection. The risk/benefits of that is outside my league...for more, go ask an amazing vaccinologist/immunologist nerd :)
On treatments, there are two monoclonal antibody 'cocktaills' that have promise, and will likely be used here. One by Regeneron and another by Mapp Bio. Doses are limited however, and there will be some logistical hurdles in getting these used quickly.
In today's video announcing the U.S. is withdrawing its previous funding commitment to GAVI, RFK Jr spends more time attacking vaccines than GAVI itself.
And he justifies the death of millions of children because he didn't like GAVI's social media policies on Covid vaccines.
There was almost unanimous rebuke from clinical organizations that should give us all pause.
These are the doctors that take of every American — from obstetricians to pediatricians to family practitioners—that ALL came out today to denounce RFK's move today.