On this special bonus COVID-19 update, Keith discusses the reopening of schools; the state of coronavirus testing in the United States; the intersection of hurricane season and the pandemic; and recent news about vaccine development and related clinical trials.
Let’s face it; teachers are understandably scared. However, almost no one talks about administrators, janitors, people who prepare food, and bus drivers. And what will happen when there’s a teacher, bus driver, administrator, or student who tests positive? Are schools really prepared? Parents don’t know what to do and kids are lacking socialization, so how do we keep them safe?
We’re all concerned for our children and students, from pre-school to graduate school. So many lives are upended, and there’s nothing worse than watching dreams, goals, and burgeoning careers thwarted or stymied. Our college students deserve our attention, love, compassion, and care right now.
In Israel, opening schools too quickly without a solid plan backfired and there were widespread infections.
From The New York Times:
“Confident it had beaten the coronavirus and desperate to reboot a devastated economy, the Israeli government invited the entire student body back in late May. Within days, infections were reported at a Jerusalem high school, which quickly mushroomed into the largest outbreak in a single school in Israel, possibly the world. The virus rippled out to the students’ homes and then to other schools and neighborhoods, ultimately infecting hundreds of students, teachers and relatives. Other outbreaks forced hundreds of schools to close. Across the country, tens of thousands of students and teachers were quarantined.”
Chicago’s schools, the 3rd largest in the country, has decided to go 100% online. There have recently been 250 new cases in Chicago per day, so they are letting the science guide them. New York City, the largest district in the US, is opening in September, with students attending in-person classes 1-3 days per week. Some teachers are threatening to stage a sickout and their union may sue the city.
Sanjay Gupta’s CNN coronavirus podcast covered education every day of the week of August 3rd, and I highly recommend those episodes for a deep dive into the situation.
Speaking of testing, turnaround time on testing in the US is far too slow according to most experts. Thus Louisiana, Massachusetts, Maryland, Michigan, Ohio, and VA are banding together in a 6-state testing compact, bulk purchasing 3 million rapid tests and through cooperation with the Rockefeller Foundation and two manufacturers.
We’re now testing about 750k people per day, far too few according to experts, and testing chemicals are in short supply.
If people don’t receive test results within 1-2 days of testing – and instead wait up to 2 weeks in some locations – those test results are essentially useless as those individuals who test positive have not been quarantining and have been unwittingly spreading the virus. Studies also show that there are racial disparities in access to testing and turnaround time. And with contact tracing falling apart at the seams in many states and cities, how do we contain a virus that continues to spread?
On the brighter side, it has been reported that some promising preliminary data is coming in regarding one vaccine of many currently in clinical trials. CNN reports:
“Novavax, Inc. released Phase 1 data Tuesday from 131 volunteers showing that after two doses of the vaccine, participants developed neutralizing antibodies at levels more than four times higher on average than the antibodies developed by people who had recovered from Covid-19. Neutralizing antibodies fight off the virus that causes Covid-19.”
The New York Times Virus Tracker is a very good resource for following the many vaccines currently in some level of development or testing.
The following is from the New York Times:
“Work began in January with the deciphering of the SARS-CoV-2 genome. The first vaccine safety trials in humans started in March, but the road ahead remains uncertain. Some trials will fail, and others may end without a clear result. But a few may succeed in stimulating the immune system to produce effective antibodies against the virus.
PRECLINICAL TESTING: Scientists give the vaccine to animals such as mice or monkeys to see if it produces an immune response.
PHASE I SAFETY TRIALS: Scientists give the vaccine to a small number of people to test safety and dosage as well as to confirm that it stimulates the immune system.
PHASE II EXPANDED TRIALS: Scientists give the vaccine to hundreds of people split into groups, such as children and the elderly, to see if the vaccine acts differently in them. These trials further test the vaccine’s safety and ability to stimulate the immune system.
PHASE III EFFICACY TRIALS: Scientists give the vaccine to thousands of people and wait to see how many become infected, compared with volunteers who received a placebo. These trials can determine if the vaccine protects against the coronavirus. In June, the F.D.A. said that a coronavirus vaccine would have to protect at least 50% of vaccinated people to be considered effective.
APPROVAL: Regulators in each country review the trial results and decide whether to approve the vaccine or not. During a pandemic, a vaccine may receive emergency use authorization before getting formal approval.
COMBINED PHASES: Another way to accelerate vaccine development is to combine phases. Some coronavirus vaccines are now in Phase I/II trials, for example, in which they are tested for the first time on hundreds of people. (Note that our tracker would count a combined Phase I/II trial as both Phase I and Phase II.)
“The Chinese company CanSino Biologics developed a vaccine based on an adenovirus called Ad5, in partnership with the Institute of Biology at the country’s Academy of Military Medical Sciences. In May, they published promising results from a Phase I safety trial, and in July they reported that their Phase II trials demonstrated the vaccine produced a strong immune response. In an unprecedented move, the Chinese military approved the vaccine on June 25 for a year as a “specially needed drug.” CanSino would not say whether vaccination would be mandatory or optional for soldiers.”
DISCLAIMER: In these episodes regarding COVID-19, I reference the most up-to-date information I can, as well as adding personal opinions and reflections from me and my guests. Please note that the situation is changing by the moment, and any information shared in the course of any episode may not apply once new data or evidence emerges. Please also note that nothing shared in the course of any Nurse Keith Coaching COVID-19 podcast is intended for diagnosis or treatment; please consult your healthcare provider, your local Department of Health, the CDC, the WHO, or other reputable evidence-based sources.
If you hear or read something I have shared that appears to be erroneous, if you can, please send an email me directly at firstname.lastname@example.org. Thank you for understanding, stay safe, and keep informed.
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