Tag Archives: COVID-19

I Got The Moderna Vaccine! Here’s What It’s Like.

At 1:48pm today New Jersey time, I got my vaccine!

I’ve been waiting for this moment for many months, and I’m so grateful to have a chance to get it. It was the Moderna vaccine and I got it through the Hudson County vaccination site. So far, I feel 100%!

Having lived through the dark period of spring 2020 in the New York City area, when sirens were almost constant and my neighbors were dying in huge numbers, reaching this moment is cathartic. It prompted a lot of feelings for me: relief, gratitude, and hope!

So, what’s it like? This is a drive through site, and I don’t own a car, so I took an Uber. The driver very patiently waited with me in the lengthy line to get the jab. Many cars slowly snaked ahead in the cold snow.

Once we finally made it to the front, I showed a QR code on my phone that the county had e-mailed me. Shortly therafter, the nurse came up and asked if I had been feeling sick today. Then, she gave me the shot!

I barely felt a thing, which was surprising. Since then, I’ve had no side effects that I can discern. I hope it stays that way!

Just after the shot, we took the picture above. It’s actually staged…she had already given me the jab before we ever thought to document the moment for posterity! So she posed with the needle near my arm, and I took a snap to record this wonderful moment in my life that I’ve waited so long for.

“This is a historic moment,” she said. I agreed.

If you’re still trying to get an appointment, don’t give up! I’ve been checking every area provider’s website repeatedly for months. And I almost wasn’t going to check again today, but I did, and found an appointment for just 90 minutes away! Perhaps someone cancelled last minute. The best strategy seems to be to check over and over.

Now, I can begin to plan for a life after COVID. A week after the 2nd dose, which will be around the end of March, it should have achieved its full 94% efficacy. I will finally be able to get on a plane and visit my mom for the first time since December 2019! And I’m looking forward to getting some great protection even sooner: just 2 weeks after the first dose, the vaccine is 80% effective.

I really encourage everyone to get this vaccine, although I know each person has to make their own decision. COVID may be something to fear, but this really isn’t! If I didn’t keel over after, you won’t either! 🙂

The Miracle Particles Behind COVID Vaccines

The particles that the Pfizer and Moderna vaccines rely on are 1/1000th the width of a human hair. They’re called lipid nanoparticles, and they’re revolutionizing medicine as we speak.

The Pfizer and Moderna COVID vaccines work by sending mRNA to your cells. The mRNA tells the cells how to make proteins that block the virus. But you can’t send the mRNA on its own, because it would be repelled and flushed out through the kidneys.

The mRNA needs a wrapper, and that’s where the lipid nanoparticle comes in. The mRNA molecules are negatively charged and so are our cells. These two negatives push each other away. But, the nanoparticle can make it inside the cell.

Once inside the cell, the particle faces another barrier. The cell wraps it in a container called an endosome, because the cell doesn’t want to be contaminated. So, the lipid nanoparticle has to be specially designed to escape that endosomal prison.

Decades of research has gone into these particles, and they can now escape and spread the necessary information into the watery substance inside the cell (called the cytoplasm). Our commitment to funding basic science decades ago is paying off today in ways we could never have anticipated.

I learned a great deal about these incredible particles today at an online seminar hosted by the journal Nature with Kathryn Whitehead of Carnegie Mellon University and Yizhou Dong of Ohio State University. They gave some great perspective on the development of this amazing technology.

One thing Professor Whitehead mentioned was that despite concerns that the mRNA vaccines are too new and unproven to be safe, the lipid nanoparticles they use have existed for decades. In fact, she said she’s had research rejected for publication because these particles are considered too old hat!

I also finally learned why the vaccines have to be stored at such cold temperatures: molecules will start moving around too much once the temperature rises, so the lipid nanoparticles could come apart. Perhaps one reason Moderna’s vaccine doesn’t need quite as cold of storage is that they’ve been researching these particles for much longer than Pfizer/BioNTech, so their particles may be a bit more stable.

Beyond COVID, lipid nanoparticles and the mRNA therapies they’re a part of could be used for other viruses like the flu, Zika and Ebola. They may also be used as cancer immunotherapies. (This echoes what the co-founders of BioNTech said recently.)

These particles seem likely to underlie an entire new generation of medicines. I’ll be keeping a close eye on them, microscopic as they are!

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Photo: “2020_06_020100 – a human cell attacked by Covid-19” by Gwydion M. Williams is licensed under CC BY 2.0

From COVID Vaccines to Library Cards, Government is Failing Us. Here’s the Way Out.

It’s bigger than party.

The Problem

This all started when I had to renew my library card.

I got an e-mail requesting a picture of a photo ID with my current address on it. I got my driver’s license and passport before I moved here two years ago, so I asked how else I could renew my card and continue to experience the joys of reading. The friendly folks at the library demanded a photo ID and two (!) proofs of residence.

This got me thinking about how a lot of things in this country are working. In short: not well.

We are carefully following rules and accomplishing nothing. We put in place an arcane system of regulations and lose sight of our overall goal. And it goes way beyond your little local library.

The Problem is Everywhere

Early in the pandemic, getting a COVID test was next to impossible. I volunteered to schedule them at a nearby hospital in March, and the desperation in the voices of the callers struck me.

Why was it so hard to get a test? The CDC first required all labs to use their test, which did not work, rather than letting labs develop their own.

The University of Washington sought to make a COVID test on its own in February. Widespread testing at that time might have stopped the pandemic in its tracks. They made a test, filled out the mountain of documents the government required, and sent them off.

One problem: regulations required they also mail a USB drive or CD-ROM containing the documents. Here’s the lab’s director, Keith Jerome:

We’ve got a lot of scientists and doctors and laboratory personnel who are incredibly good at making assays. What we’re not so good at is figuring out all the forms and working with the bureaucracy of the federal government.” Jerome said that Greninger had to call and e-mail the F.D.A. multiple times to figure out what they needed to secure an E.U.A. “At one point, he was very frustrated because he’d e-mailed them what we were doing so they could review it,” Jerome said. “But legally you also had to mail a physical copy. Here we are in this SARS-CoV-2 crisis, and you have to send them something through the United States Postal Service. It’s just shocking.” (The F.D.A. has since dropped the requirement to send a CD-ROM or USB drive with a copy of the application.)

The New Yorker

Frankly, as much as I try to stay calm, reading this sort of thing makes my blood boil. Still not convinced? Well, let’s mosey over from the CDC to the Pentagon.

The Department of Defense took a year to get cloth masks for our soldiers. A year! But at least they got a great deal. Each one comes at the bargain price of $45:

It took a full year for the service to design, approve and distribute a face mask — called a Combat Cloth Face Covering, or CCFC — for its soldiers, an effort that required an additional $43.5 million in contracts to provide temporary solutions. That comes out to about $45 per mask, if you assume every active-duty, National Guard and Reserve soldier received one. A pack of 20 N95 masks at Home Depot costs about $20.

And yet, the Army congratulated itself on the “expedited” timeline, compared to the 18- to 24-month procurement cycle such an effort would normally take.

“The system worked as designed,” tweeted a former Marine.

And that is precisely the problem.

This from Defense News, by way of the excellent Alex Tabarrok at Marginal Revolution.

If you’re still unconvinced we have a problem here, I’ll give you one last example. Here are some of the ways you can get a COVID vaccine in Hudson County, NJ where I live. Each one has a separate website, and some have no website at all! I haven’t been able to find an appointment on any of them yet:

An AirBnB engineer in New York, Huge Ma, made his own website for $50 that aggregates the similar patchwork of vaccination sites in New York into one slick system. Government had most of 2020 and millions of dollars to do something similar, but never saw fit to do it.

How We Can Fix It

Huge Ma shows us what one capable person can do, freed of constraints. What government needs to do is to get some capable people together, give them an overall goal, and let them do the work.

What might that look like? Get together a few of the best IT people in the New Jersey state government, call in a couple outside experts (perhaps Mr. Ma!), and tell them “We need to get people vaccines. Make it happen.”

Getting together a group of capable people, giving them an endpoint, and letting them figure out how to get there is how the best organizations work. The superb book Good to Great details how that process has succeeded at one organization after another.

In addition, we need all the Huge Ma’s we can get. Let’s have private citizens make things without permission, and also agitate to get government to work better.

With that in mind, I will now politely submit all the required documents for my new library card, but also enquire how we might make this process easier for others in the future. 🙂

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Photo: “President Trump Meets with the Governor of New Jersey” by The White House is marked with CC PDM 1.0

Brazil’s Society is Collapsing as COVID Slams its Economy

There is a huge increase in homelessness in Brazil, per Der Spiegel. Many have lost jobs due to the COVID pandemic, leading to a second humanitarian crisis, this one economic. I found this quote from a factory worker who recently lost his job particularly striking:

“I never thought I would end up in this situation,” he says, “and suddenly …” He snaps his fingers and his eyes fill with tears. The worst, he says, is the hunger and the constant feeling of being dirty. “It is the most terrible experience I have ever had in my life, the biggest humiliation.”

This is a man who worked…he was not lazy. But unfortunately, he has still lost everything. Financial relief from the government, on which one third (!) of society depends, is expiring:

…the government in Brasília ceased paying out an emergency allowance for the poor struck by the crisis as of January. Fully 67 million Brazilians – almost a third of the population – had been relying on the 600 real (around 90 euros) each month. “It helped people in the favelas pay for rent or food,” says Kohara. And they have no savings, he adds. Their situations are now so tenuous that they could end up on the streets from one day to the next.

This drives home the importance of stimulus measures in the US. In addition, perhaps an international poverty relief effort is needed.

More here.

Photo: “Slums in Rio de Janeiro, Brazil” by World Resources is licensed under CC BY-NC-SA 2.0

Numerous COVID Vaccines are 100% Effective at Preventing Death

Of all the possible outcomes from COVID infection, clearly death is the one we want to prevent above all. We commonly see vaccine efficacy numbers from the 60’s to the 90’s, but that figure generally refers to how successful the vaccine is at preventing a COVID infection with any symptoms.

How effective are the vaccines at preventing you from dying of COVID? Turns out, regardless of whether you look at trial data from Pfizer, Moderna, AstraZeneca, Johnson & Johnson, Novavax or the Russian Sputnix V vaccine, you don’t see a single COVID death.

I came across this information in fascinating Twitter thread today from the eminent Yale virologist Dr. Akiko Iwasaki:

This is a simple and highly relevant message I’d like to see broadcasted far and wide…vaccinated people don’t die of COVID. Period.

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What is Quercetin and Can It Protect You Against COVID?

At first, I couldn’t even spell it! I first heard about quercetin in this interview with Dr. Mark Gordon, and was intrigued that an over-the-counter supplement might help protect against COVID and even colds and flus. But I was a little skeptical, so I decided to do some digging.

I found this widely cited study which concluded that although we can’t say to a certainty that quercetin can protect us from COVID, there is some good evidence for it, especially if taken with vitamin C. What’s more, the risks seem quite low:

Quercetin displays a broad range of antiviral properties which can interfere at multiple steps of pathogen virulence -virus entry, virus replication, protein assembly- and that these therapeutic effects can be augmented by the co-administration of vitamin C. Furthermore, due to their lack of severe side effects and low-costs, we strongly suggest the combined administration of these two compounds for both the prophylaxis and the early treatment of respiratory tract infections, especially including COVID-19 patients.

The study authors are careful to note that this is an “experimental strategy,” and I found another study that questioned whether using quercetin to protect against COVID is well-founded.

That said, given the reasonable cost, low risk, and emerging evidence of efficacy, I decided to order some here. I’ll take it in conjunction with the vitamin C and vitamin D I already take and hope for the best!

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What Captain Sir Tom Meant to Me

My wife was the first person to tell me about Captain Tom, a man in the UK nearing his 100th birthday who was walking across his small garden day after day to raise money for the NHS. At that time, things in the New York area, where we live, were at their worst.

I remember the disturbing sights of that time. What was odd about them was I’d just catch a glimpse of what was happening. I would wonder if what I saw was what I thought it was. I seemed to see more hearses than I used to, but then who could be sure? I saw a large trailer outside a medical facility in Greenwich Village…was that one of the trailers that held bodies?

Other things were less equivocal. I saw a white panel truck pull up in front of a funeral home in Lower Manhattan. They had evidently run out of hearses. And an ambulance seemed to pass our building almost every minute.

I asked my wife if she had ever heard so many sirens. Was I just imagining things? She agreed she’d never heard so many at once. This made me realize I wasn’t imagining. I don’t know if that made it better or worse.

At this time, I felt helpless to stop the catastrophe surrounding me, as I’m sure many did. But Captain Tom’s example from afar cheered me. Of all people, who would be in a worse position to help than someone who is 99 years old and frail? But he determinedly crossed his garden back and forth, unconcerned with whatever limitations he might face. He just kept moving. I think he gave a lot of us the courage to keep moving to.

And bit by bit, his seemingly small act made a huge impact. He raised 33 million pounds ($45 million) for the NHS, perhaps saving many lives.

At 99 years old, one would think he had already given all he had to give. He had served his country in World War Two and raised a wonderful family. Who would’ve thought that his greatest achievement was still ahead of him?

When he started his walk, Captain Sir Tom was still recovering from serious injuries from a fall that included a punctured lung! But he saw what he could do, not what he couldn’t, and set about doing it for the good of others. And if someone could accomplish so much at age 99, imagine what we could do as well!

Captain Sir Tom Moore showed me what one human being can do, even in the face of the worst things. He showed me that people cannot be stopped; that the human spirit can triumph over anything, if we try.

It’s a shame to lose him, but he was here when we needed him most.

Captain Sir Tom, we’ll miss you!

Is There Real Science Behind Taking Vitamin D to Prevent COVID?

Many of us have heard that vitamin D might protect us from COVID, but is there real science behind these claims? Yesterday, I received a very thoughtful message from Dr. Peter Attia on the subject. Dr. Attia cites a randomized controlled trial from Spain that found the following:

patients not treated with vitamin D had 33.3 times the risk of ICU admission compared to patients treated with vitamin D

Vitamin D seems to help with disease severity even if it doesn’t prevent you from catching COVID in the first place. Dr. Attia also provides some good perspective on dosing.

there is virtually no risk to supplementing, say, 5,000 IU/day

I had heard that too much vitamin D could cause kidney stones, but Dr. Attia put those concerns to rest as well:

Too much vitamin D results in hypercalcemia, most commonly due to an overproduction of calcium that can result in kidney stones. However, vitamin D toxicity is not easy to come by: a review article noted that all published cases involved an intake of at least 40,000 IU/day. Even though the Food and Nutrition Board established a conservative dose threshold of 2,000 IU/day, some studies suggest that doses of up to 10,000 IU/day is safe for most adults.

I’ve taken 5,000 IU of Vitamin D for nearly 3 years with no ill effects that I can discern. I based that decision on information from this book that it may boost testosterone levels. I was also informed by this book, which noted that those who live in the north struggle to get sufficient vitamin D in the winter, regardless of the amount of sun exposure. The next step I need to take is to get blood levels of vitamin D taken to confirm the supplementation is getting me into the healthy range.

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We Added 2 New Vaccines To Our Arsenal in One Day!

Johnson & Johnson CEO Alex Gorsky.

In difficult times such as these, we have to celebrate our wins. We had two big ones today: both the Johnson & Johnson and Novavax vaccines were found to be effective against COVID. J&J was 66% effective and Novavax 89% effective.

The FDA should approve both ASAP. Indeed, the FDA is considering authorizing the Novavax vaccine based on data from overseas. J&J is likely to be authorized in February. Since many are dying each day, each day of delay is very costly.

Both were less effective against the variant from South Africa, with Novavax below 50% efficacy there. But Novavax is working on a new formulation to counter that variant.

We face a constrained supply of vaccines, so any effective ones we can add to our toolkit are a huge win!

Photo: “File:Alex Gorsky at World Economic Forum.jpg” by World Economic Forum is licensed under CC BY 3.0