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Should You Worry About COIVD-19 Mutations? By Glenn Ellis

Feb. 1, 2021

Should You Worry About COVID-19 Mutations?
By Glenn Ellis

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(TriceEdneyWire.com) - The newest mutations of the COIVD-19 showing up in the United States will bring with it, over the next three or four weeks, the most difficult days of the pandemic we have seen so far. Studies in laboratories show that a mutation makes a person’s antibodies less effective at killing the virus. Viral mutations help a virus to disguise parts of its recognizable traits, so the pathogen might have an easier time slipping past immune protection. These mutations can also tell us what we don’t know…what lies ahead, in terms of other mutations and/or future pandemics.

The job for all of us now is to, first and foremost, survive; stay alive; and be as healthy as possible. Our second “job” is to learn and educate ourselves as much as we can; empowering ourselves with better understandings on how to ask the “right” questions; where to go for credible; factual information that you can trust; and to “personalize” the pandemic, by learning exactly what is necessary for you and your family to be safe and protected during this, and future pandemics…rest assured, there will be others. None of the experts can predict when; but they all agree that it’s not if, but when. Among the many options this pandemic is providing for us to “learn”, we are being introduced to a range of new questions, as a result of the introductions of mutant variants.

Mutations in viruses -including COVID-19 - are not new nor were they unexpected. All RNA viruses mutate over time, some more than others. We are all familiar with the how flu viruses change often, which is why you get a new flu vaccine every year. When viruses mutate, generally, they either kill the virus (a type of “virus-suicide”) or they can have no effect whatsoever on the normal behavior of the virus. To date, we are seeing variants (or mutant strains) from the United Kingdom; South Africa; and Brazil all hitting the United States at the same time, while we’re battling furiously against the rage of the initial version of COVID-19. Now, that there technically four different strains of a deadly virus circulating.

Scientists initially felt there was no cause for concern about the vaccines being distributed not being effective against emerging mutations, after hearing of a mutant strain being reported in United Kingdom. South African officials noticed that their mutant strain not only appeared to make the virus more able to spread (or transmit), and more capable of evading the immune system’s response; alarms bells sounded when the antibodies produced in people who had previously recovered from COVID did not completely neutralize a variant. This mutation phenomena became even more concerning when, contrary to all prior global clinical experience with the virus to date, this month researchers reported, for the first time that the mutant strain shows initial indications that it has the ability to evade the vaccine.

News of this has caused mixed reactions from different stakeholders.

You see, when this thing first made its’ appearance, public health experts and scientist knew it would bad, but they felt that at least it would be stable. As it turns out they were only half right; it is bad, but it is anything but stable.

Pfizer and Moderna, have been reluctant to support any changes to their respective vaccination schedules. The drug makers on grounds that the vaccines weren’t tested and so their efficacy is unknown. On the face of it, this position seems sensible; yet under current circumstances, it is dangerously overcautious. Some researchers and scientists think more lives would be saved by providing just one dose of the vaccine as soon as possible, or as others think, maybe we should provide just one dose of the vaccine to all people who face the highest risk of dying from Covid-19, whoever they are, for whatever the reason.

With all of the uncertainty surrounding mutations of COVID-19, the last thing we need to do is to minimize the potential of the vaccines to control this pandemic. We don’t have to worry that the mutation will make the existing vaccines available useless. The vaccines available now have what’s known as a polyclonal response, causing armies of antibodies to attack different parts of the virus. When the virus starts to mutate, causing changes to any of those target sites this increases the potential for the vaccine to be less effective, or not work at all.

There is growing concern among scientists who think the coronavirus could eventually change so much that the vaccines could reach a pint of providing no immunity. The more that people are protected from the virus - either through vaccination or infection – the more evolutionary pressure that puts on the virus to survive by mutating. Even though it would take years to reach that point of evolutionary mutation, could take years, the vaccine makers are confident that can modify their formulas to match a newer variant in only take weeks.

In the spirit of empowering the community with adequate information to make informed decisions, keep in mind that we are not helpless, we could wipe COIVD-19 out, if everyone wore a mask for 4 weeks.

Remember, I’m not a doctor. I just sound like one! Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Bioethics Fellow. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

COVID-19: Have You Figured out Face Masks Yet? By Glenn Ellis

Jan. 12, 2021

COVID-19: Have You Figured out Face Masks Yet?
By Glenn Ellis

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(TriceEdneyWire.com) - Will the vaccine slow down the rate of transmission of Covid-19?

This is one of the key questions that scientists will be seeking to answer over coming weeks. The vaccines now being administered are designed to protect people from severe side-effects of the disease. They were not developed to block transmission of the virus. They are meant for you to be protected against serious illness but still carry the virus and spread it to others. However, scientists believe (and are hoping) that the vaccines should reduce viral load in those inoculated and there should then be a reduction in transmission. In the meantime, face masks will continue to be the order of the day.

Getting use to everybody wearing masks is certainly a new experience for us grownups, and one that we probably never imagined. It looks like wearing face masks will be a way of life for us for the near future. But can you imagine how confusing, scary, and even traumatizing face mask wearing is for kids and young people? I honestly don’t know how I would have handled it when I was a kid. Adults and parents in the lives of our young people must be vigilant about providing the information and support they will need.

For starters, what kind of masks are best for protection? Sure, any mask will have some effect, but cloth masks are less than half as effective as surgical masks at protecting the person wearing the mask. Surgical masks are two to three times as effective as cloth masks. Remind young people that it is important that teachers, postal workers, delivery people, cashiers, restaurant workers, and anyone they come in contact with whose work involves regular contact with other people should be wearing a mask.

I know we’ve heard all about N95 face masks. They are tested to show they are 95 percent effective. However, not only are they more expensive, but the research has also found that there is no evidence that the N95 face masks are better at protection than the simple green or blue surgical masks. There is a reason it is standard, required gear in hospital operating rooms!

By the way, make sure we show young people know how to wear their face mask properly, a mask helps block large-particle droplets, splashes, sprays, or splatter that may contain germs, viruses, or bacteria), keeping it from reaching the mouth and nose and infecting you. The whole point of surgical masks is to help reduce exposure of your saliva and respiratory secretions to others. In medical history, the surgical mask was invented not to protect the surgeon, but to protect the patient from the surgeon; you know, coughing into the open surgical wounds and causing infection in the patient. So, it doesn’t protect the doctor from the patient. Keep that in mind when you need motivation to maintain social distancing.

So how good is a good cloth mask? Single- and double-layer cloth masks made from lightweight, low-thread cotton are the least effective. I know they have some very stylish, cute cloth ones out there, but the researchers also found that gaps at the edges of an ill-fitting, flimsy cloth mask can reduce filtration efficiency by 60 percent. If you walk around any city in the U.S., some people are wearing masks over their noses and other ones are wearing them hanging off one ear. But cloth masks are far from useless; they are the best alternative to the more expensive N95, and they offer almost the same protection. Even the CDC says that when surgical masks are unavailable, cloth masks are a more suitable option for use in the general public.

As parents, we have a lot of impact on the meaning that children attach to their experiences. From about the age of 8 months, children look at others’ reactions to see how they should respond. Psychologists call this “social referencing.” For example, when kids see a dog for the first time, they look at the dog, then look up at their grown-ups to see, “Should I be scared, here?” If the grown-ups are calm or positive, it makes it easier for the kid to be calm or positive.

The same thing applies to masks: If we are calm and positive about wearing masks, it will be easier for our kids to be calm and positive about them, too. On the other hand, if our words or reactions say, “This is terrible! This is unbearable! You can’t possibly tolerate this!” we put an extra burden on our children.

The most important tips to continuously share with children and young people about face masks is: Don’t leave your nose or mouth uncovered. Don’t remove the mask while around others in public. Don’t share your mask with family members or friends. And remember, a mask is not a substitute for social distancing. Let’s continue to take care of our young people!

Remember, I’m not a doctor. I just sound like one! Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. 

Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Bioethics Fellow. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics.

For more good health information visit: www.glennellis.com.

COVID-19: A New Year with More Meaningful Resolutions By Glenn Ellis

 Dec. 28, 2020

COVID-19: A New Year with More Meaningful Resolutions
By Glenn Ellis

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COVID-19: A New Year with More Meaningful Resolutions
By Glenn Ellis

(TriceEdneyWire.com) - According to a new survey from CIT Bank conducted by The Harris Poll, despite the turbulence of 2020, Americans are not turning their backs on making goals for the year ahead. In fact, more Americans are planning to make New Year's resolutions for 2021 (43%) than did so for this year (35%).

As we near the end of 2020, many of us are looking to 2021 as a fresh start. Do you have a New Year’s resolution or goal for the new year? Did you have to put off your 2020 goals because of COVID-19? Has the pandemic given you a new perspective that makes your resolutions - or how you plan to achieve them - different than what you might have done in the past? How have your goals for the future changed in our “new normal”?

After almost the entirety of 2020, we are learning more about COVID-19 every day. Much of what we have learned should factor in each of our list of New Year’s Resolutions. These lessons are relevant for children as well as adults of all ages. While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. By now it should be clear that COVID-19 is an equal opportunity killer. 

What we have witnessed and learned from COVID-19 in 2020 should inform us on making New Year’s resolutions that matter, and ones that we should be committed to keeping moving forward. Here are some of the key takeaways: chronic disease and vaccines.

Chronic Diseases: The COVID-19 health crisis has caused massive disruptions in diagnosing and treating people with deadly but preventable diseases, such as diabetes; high blood pressure; obesity, etc.. People with chronic conditions are more vulnerable to catching and dying from COVID-19. In addition, their exposure to risk factors - such as substance abuse, social isolation and unhealthy diets - has dramatically increased during the pandemic.

Because of this insight, it is imperative that all resolutions for the New Year include particular attention to limits or restrictive availability of food supplies, so careful planning on how to maintain a good, consistently healthy diet. Care must also be given to considerations on physical activity and exercise. Regular physical activity helps improve your overall health, fitness, and quality of life. It also helps reduce your risk of chronic conditions like type 2 diabetes, heart disease, many types of cancer, depression and anxiety, and dementia.

Finally, a word about chronic conditions and medical care. Pharmacies and community clinics are less able to handle the demands than ever. Make sure your resolutions include a promise (to yourself) to be as compliant as possible with the treatment plans and/or medications prescribed for your condition(s). Commit to monitoring your blood pressure and/or blood sugar at home on a daily basis. Bottomline? The New Year must find folks with chronic conditions making resolutions around lowering blood pressure and/or blood sugar; reducing BMI; and maintaining a healthy daily calorie intake.

Vaccines: The recent Kaiser Family Foundation study found that 35% of Black Americans would probably or definitely not get the vaccine if it was determined to be safe by scientists and widely available for free. Washington Post columnist Michele Norris captured the essence of this phenomenon. “Vaccine hesitancy from Black Americans is different from an “anti-vaxxer” stance. It’s not that Black Americans don’t believe in vaccines. They don’t trust a public health system that has in too many cases engaged in grievous harm by experimenting on Black bodies without consent or ignoring the specific needs of Black people.

What’s the solution for your resolution? Information is the best medicine. Add to your list a determination to improve your health literacy. Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.

Do you have any questions related to the coronavirus vaccine? Do the vaccines protect against both severe and mild illness? Can the vaccines stop virus transmission? How long will the vaccines be protective? Most of us won’t have access to the vaccine anytime soon. Some of the “experts” are saying that by Memorial Day, end of June, any Americans who want a vaccine will have their hands on a vaccine. Use the time wisely and find out all you can about vaccines. If improving your health literacy is one of your New Year’s resolutions, whatever you decide about taking the vaccine will not be based on fear and suspicion.

In closing, let me remind us that at the heart of our New year’s resolutions should be ample opportunity on us to work on our humanity. We see suffering and hardship brought on by the pandemic, all around us. Almost overnight we’ve become more and more, a nation of have’s and have nots. There's a lot of distress out there: If we can set goals that aim to help others, those kinds of goals will, in turn, also add to our own well-being. Think about the ways in which you can contribute to your family, your community, and to the world.

Remember, I’m not a doctor. I just sound like one, Take good care of yourself and live the best life possible!

 The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

Are You Taking the COVID-19 Vaccine? By Glenn Ellis

 Dec. 7, 2020

Are You Taking the COVID-19 Vaccine?
By Glenn Ellis

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(TriceEdneyWire.com) - Now comes the moment of truth. The time has come when each of us will have to make a personal decision about whether to take the COVID-19 vaccine or not. Following months of the most unimageable experience of living in the midst of a global pandemic, the promise of the vaccine hoped for is finally at hand. Within days or weeks, people are going to start receiving the first of a two-dose vaccine. As opposed to influencing your decision or telling you what you should do; this column will contribute to making sure that your decision is an informed decision.

Making sure that you have asked the right questions, especially about the stuff you don’t understand, is the important thing you can do to guarantee that the decision you make is one that you can live with.

Here are a few areas that look at some of the most common questions that folks have posed to me. I thought you might find them helpful:

What’s different about this vaccine? The COVID-19 vaccines are different because they use a “new” technology called mRNA. The CDC describes how it works by saying, “To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, they teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies”.  

This vaccine works by providing a “genetic code” for our cells to produce viral proteins. Once the proteins (which don’t cause disease) are produced, the body launches an immune response against the virus, enabling ta person to develop immunity to that virus should it ever show up again. This is a new technology with vaccines in humans. Even though there has been research in the past, it has not been successful until now.

Whereas in the past, vaccines worked by introducing small parts of either live or inactive viruses, in order to create a “memory” in the immune system against a future invader of the same type of virus; mRNA works in a whole different way. They actually introduced a protein in the injection, which causes the immune system to react and attack it as an invader. The protein then has a “plan” programmed (so to speak) inside to instruct the immune system to create antibodies for the COVID-19 virus, should it ever show up.

Clearly, this is a remarkable breakthrough in the world of vaccines! However, there are some concerns that worry some experts. mRNA’s protein is a foreign invader, and there is the possibility, albeit it slight, that it could trigger a immune response separate from the one intended, and cause an inflammatory response from the immune system. This was at the heart of some of the unsuccessful attempts with mRNA as a vaccine.

There is also the question of the effectiveness and safety in those people with chronic medical conditions. Is there data on how it works in those populations and communities? Almost 60 percent of American adults have at least one chronic medical condition. 40 percent of U.S. adults are obese; one of the most common underlying conditions that increases one’s risk for severe illness.  The more underlying medical conditions people have, the higher their risk. What percentage of the study population reflected people with pre-existing chronic conditions?

And then there are our seniors and elderly. Elderly and older adults are at greatest risk of severe disease and death from COVID-19. People older than 65 years makeup 9% of the world’s population, and yet they account for 30% to 40% of cases and more than 80% of deaths. A review of recent research literature shows that older adults were excluded from more than 50% of COVID-19 clinical drug trials and 100% of vaccine trials. Again, what percentage of the study population reflected people who were older?

According to the CDC, all but one of the COVID-19 vaccines that are currently in Phase 3 clinical trials in the United States use two shots. The first shot starts building protection. A second shot a few weeks later is needed to get the most protection the vaccine has to offer. What this means is that most of shouldn’t expect to receive and see protection from the vaccine (assuming it works, and enough people take it) until late spring or early Summer 2021. This means that the best thing all of us can do, regardless of our decision on taking the vaccine, is to remain vigilant in keeping up the protective measures of sanitation, physical distancing, and wearing face masks.

Finally, keep in mind that what we know so far about the vaccines is based on preliminary data. To date, there have been no peer-reviewed published studies. If it walks like a duck, and quacks like a duck, it’s a duck. This is still a clinical trial. Learn all you can; educate yourself and your family; make an informed decision. Don’t forget that Information is the Best Medicine”.

Remember, I’m not a doctor. I. just sound like one. Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics (2018) and Narrative Bioethics (2020). He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

 

 

 

COVID-19: A Real Different Holiday Season By Glenn Ellis

Nov. 23, 2020

COVID-19: A Real Different Holiday Season
By Glenn Ellis

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(TriceEdneyWire.com) - As if losing the ability to gather for each of our traditional forms and places of worship, as well as mourning and burying our dead according to our customs wasn’t all we thought we could bear, COVID-19 continues to take its’ toll in unexpected ways. For most, this is the first time that we have to make a decision to forgo the annual holiday trip or skip the family gathering. No seeing the joyful faces of families and friends, as we have all come to expect and enjoy.

For some of us, this is the time to make amends for yearlong petty disputes; for others it’s a season to introduce new babies or significant others to the family; and then there are those for whom it is the therapeutic intervention we need to return us to our “roots’, and be infused with the familial and ancestral spirit that enables us to cope with the challenges of our daily lives.

It’s time for us to start to pay attention to the emotional and mental toll that the pandemic is causing in all of our lives; and whether we like it or not, we’re going to have to cope not just with our own emotions, but our family’s emotions, too.

Let me acknowledge that I am under no illusion that everyone doesn’t share this degree of caution or concern. We’ve seen a wide range of reactions to the pandemic, from those who take it very seriously to those who treat it like it’s not such a big deal. We have seen every day for the past six or seven months, that there are millions of people in this country who could care less about allowing this virus to interfere with their lives, especially during this holiday season. Even though the TSA screen over 2 million people at airports over a 48 hour period last week, I’d like to believe that most of us are like me, being cautious and following all of the CDC’s guidelines for preventive measures…like not traveling for the holidays. However, like me, many of you also have family and friends who are dismissive of the danger; and if so, you need to deal with the conflict if you have decided to skip the festivities. If your family and friends don’t think like you about the threat that this virus brings, then they absolutely won’t understand your decision not to celebrate your holiday season in a totally distant, but safe, way.

A couple of facts pointed out in research from the Kaiser Family Foundation makes clear why this concern is of particular importance for Black folks. We are “at an increased risk for serious illness if they contract COVID-19 due to higher rates of underlying health conditions, such as diabetes, asthma, hypertension, and obesity compared to whites; more likely to work in the service industries such as restaurants, retail, and hospitality that are particularly at risk for loss of income during the pandemic; more likely to live in housing situations, such as multigenerational families or low-income and public housing that make it difficult to social distance or self-isolate; and often working in jobs that are not amenable to teleworking and use public transportation that puts them at risk for exposure to COVID-19.

I don’t know about you, but every Black person I know either fits this profile or have a friend or relative who is a part of their normal holiday celebrations that they would contact if things go on as they have in holidays past. If you’ve made a decision to do things differently this year, remember that these people won’t understand, and you could find yourself in the throes of some deep resentment. Are you ready for that from the people you love and care about the most? How are you planning to approach these conversations? You might want to put some thought into it so that you will be prepared for the inevitable. The last thing any of us want is to cuase damage in our most meaningful relationships.

Always remember your responsibility to your friends and family, always make the goal to set a boundary and stick up for yourself and your family. Of course, food is a meaningful part of our cultural and history for our holiday experiences. If you live in close proximity to your family, consider a socially-distanced food exchange. So if you are not comfortable going to a family member’s house for a long sit-down meal, you can cook various dishes and drop them off.

It’s okay to admit that you’re sad and disappointed and that you’ll miss these events. But, it’s entirely possible to still turn the holidays into a positive experience with alternative plans, even if they’re not the plans you’d hoped for.

When you’re thinking about holiday rituals and adapting to new or different circumstances, ask yourself, again, if it’s something meaningful to you or something that feels like an obligation.

If it’s meaningful, think about how you can do the things to be safe, so that you can still recreate the experiences in the holidays to come.

Remember I’m not a doctor. I just sound like one! Take good care of yourself and live the best life possible! 

The information included in this column is for educational purposes only. I do not dispense medical advice or prescribe the use of any technique as a replacement form of treatment for physical, mental or medical problems by your doctor either directly or indirectly. Glenn Ellis, MPH is a Visiting Scholar at The National Bioethics Center at Tuskegee University and a Harvard Medical School Fellow in Research Bioethics and Writing. He is author of Which Doctor? and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com

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