August 25, 2020

VACCINE 101 (WITH THANKS TO NYT AND ARTICLE WRITTEN BY TWO DOCTORS WHO ARE VACCINE EXPERTS)( Adam Finn and Richard Malley

Dr. Finn and Dr. Malley are physicians specializing in infectious diseases and vaccinology.1. START HERE:  What is a vaccine, and how do vaccines work? (You might show this one to your children)
2. THEN GO HERE: Are We Looking for the Wrong Coronavirus Vaccines? “When does contagiousness peak in whom and why? And can vaccines modify any of that?
The best vaccines don’t just protect the inoculated from getting sick from a disease, they also protect everyone else from even contracting the pathogen that causes that disease…’
3. NOW WATCH THIS BASIC BUT WORTHWHILE  UTUBE: HOW VACCINES PROTECT
4. SUMMARY: “Given the communitywide benefits of accomplishing that, especially in a pandemic, current vaccine-development efforts should prioritize finding vaccines that limit the transmission of SARS-CoV-2.” (J. Harris So, the best vaccine is one that will prevent an exposed patient from getting the disease and also render any viruses he may be carrying less capable of infecting other people. Remember, he was vaccinated, and he didn’t get sick; but he was exposed and may well be carrying and shedding and spreading the virus — but our new and ideal vaccine has castrated the virus and it won’t make other people sick either).
5. Eight vaccine candidates are undergoing large-scale efficacy tests, so-called Phase 3 trials, and results are expected by the end of this year or early 2021.

(J. Harris: Harrison County is about the same for the last three weeks, despite local testing and schools starting. Good. If we are able to keep the schools open, the winter might not be so bad. Get your FLU shot).
COVID-19 Is Transmitted Through Aerosols. We Have Enough Evidence, Now It Is Time to Act (J. Harris: A certain Norweigan housekeeper/cook  found this; an aerosol is like smoke in a room and it can be breathed and rebreathed for a prolonged period. Outdoors is safer.)

Somebody stole all my lamps. I couldn’t be more de-lighted!

What’s the best way to carve wood?    Whittle by whittle.

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July 3, 2020

James Harris	10:59 AM (3 hours ago)
to Harris

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July 2, 2020

MNM REPORTS 2 NEW HARRISON COUNTY COVID CASES FOR WEDNESDAY.

Smith County COVID-19 cases jump by 36 as Tyler hospitals admit 17 new East Texas patients

Smith County COVID-19 cases rose by 36 Wednesday for a current active count of 357 as Tyler hospitals admitted 17 additional East Texas patients for the virus.

The county’s cumulative count has reached 654, which includes 357 active cases, 293 recoveries and four deaths, according to the Northeast Texas Public Health District.

This recent rise in totals comes one day after the county set a new daily highest record of 52.

Seventy-five patients from East Texas are being treated in Tyler hospitals, which is up 17 from Tuesday.

Gregg County COVID-19 cases jumped by 16 on Wednesday.

Coronavirus concerns prompt city of Galveston to close beaches for July 4th weekend

Face Shields and Containment of COVID-19Face Shields and Containment of COVID-19

Face shields offer a number of advantages. While medical masks have limited durability and little potential for reprocessing, face shields can be reused indefinitely and are easily cleaned with soap and water, or common household disinfectants. They are comfortable to wear, protect the portals of viral entry, and reduce the potential for autoinoculation by preventing the wearer from touching their face. People wearing medical masks often have to remove them to communicate with others around them; this is not necessary with face shields. The use of a face shield is also a reminder to maintain social distancing, but allows visibility of facial expressions and lip movements for speech perception.

Face shields come in various forms, but all provide a clear plastic barrier that covers the face. For optimal protection, the shield should extend below the chin anteriorly, to the ears laterally, and there should be no exposed gap between the forehead and the shield’s headpiece. Face shields require no special materials for fabrication and production lines can be repurposed fairly rapidly. Numerous companies, including Apple, Nike, GM, and John Deere, have all started producing face shields. These shields can be made from materials found in craft or office supply stores. Thus, availability of face shields is currently greater than that of medical masks.

Face shields, which can be quickly and affordably produced and distributed, should be included as part of strategies to safely and significantly reduce transmission in the community setting. Now is the time for adoption of this practical intervention.Face shields, which can be quickly and affordably produced and distributed, should be included as part of strategies to safely and significantly reduce transmission in the community setting. Now is the time for adoption of this practical intervention.

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July 1, 2020

to Harris

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June 30, 2020

HARRISON COUNTY JUDGE SIMS:

June 29, 2020 – 17 new cases (16 are in a long-term care facility) and 30 recoveries to report today. The graphic shared below from the Health District was created using data from last night. We had one additional positive come in last night that is included in today’s numbers.

Please let this jump in our numbers be an encouragement to you to practice excellent hygiene and prevent the spread. Join me in praying for all of these affected.

This coronavirus mutation has taken over the world. Scientists are trying to understand why.This coronavirus mutation has taken over the world. Scientists are trying to understand why.

At least four laboratory experiments suggest that the mutation makes the virus more infectious, although none of that work has been peer-reviewed. Another unpublished study led by scientists at Los Alamos National Laboratory asserts that patients with the G variant actually have more virus in their bodies, making them more likely to spread it to others.

The mutation doesn’t appear to make people sicker, but a growing number of scientists worry that it has made the virus more contagious. (Especially in Europe and the US)

SARS-CoV-2, the novel coronavirus that causes the disease covid-19, can be thought of as an extremely destructive burglar. Unable to live or reproduce on its own, it breaks into human cells and co-opts their biological machinery to make thousands of copies of itself. That leaves a trail of damaged tissue and triggers an immune system response that for some people can be disastrous.

This replication process is messy. Even though it has a “proofreading” mechanism for copying its genome, the coronavirus frequently makes mistakes, or mutations. The vast majority of mutations have no effect on the behavior of the virus.

“… most places where the original virus was dominant before March were eventually taken over by the mutated version. This switch was especially apparent in the United States: Ninety-six percent of early sequences here belonged to the D variant, but by the end of March, almost 70 percent of sequences carried the G amino acid instead.”

CDC ON MASKS

(J. Harris: The way I read this is that Cotton is OK; leave the surgical N95 masks for health care workers. BUT, there are now good surgical quality masks availble most anywhere in the US, so why not use them if possible? I’ll looking hard at shields. More later on shields. 

Some Experts Say Face Shields Better Than Masks for Coronavirus Protection

(J. Harris: God will forgive me for quoting from the AARP, perhaps, but good article on masks VS shields. I just order two shields, after a hot 1.25 hour meeting in a mask). 

FROM JOHNS HOPKINS:

1. Covid-19: Oxford Team Begins Vaccine Trials in Brazil and South Africa to Determine Efficacy (BMJ) Vaccine developers at the University of Oxford have begun testing their covid-19 vaccine candidate in multiple countries around the world, in the hope that it will increase their chance of determining efficacy.

2. How to Forecast Outbreaks and Pandemics (Foreign Affairs) Despite some successes, serious gaps remain in the ability of infectious disease models to inform public health policy. That is because the country has no centralized system for disease forecasting; there exists no epidemiological equivalent of the National Weather Service. That is precisely what the country needs to succeed in the fight against COVID-19 and to avoid future failures and missteps of the sort that has marred the U.S. response to the current pandemic.

3. U.S. Withdrawal from WHO Threatens to Leave it ‘Flying Blind’ on Flu Vaccines (STAT) Twice a year, influenza experts from 10 institutions around the world meet at the World Health Organization’s Geneva headquarters to pore over mounds of data. At the end of the weeklong meetings, they make decisions that affect people around the world: namely, which variants of the flu virus should be used for vaccinations the following season.

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What do you use to cut a Roman Emperor’s hair?…… Ceasers.

June 29, 2020

Note from Judge Sims: June 28, 2020 – I have not been notified of any new cases for today. I know that many have seen a number of cases announced on one of the nursing home Facebook pages. I can’t confirm an exact number since sometimes addresses are different, but it looks like about 8 of those cases are already included in the numbers reported. I expect a large number of those unreported cases to be reported tomorrow.

Please continue to take precautions and do your part to slow the spread.

(J. Harris note: So, like Gregg County, we may have patients being reinfected?”

ALL TEXAS HOSPITALS COVID CENSUS, Then click the reports labeled “COVID-19 Hospitalizations over Time by Trauma Service Area (TSA) .” Note areas of high Hispanic density are generating more cases than formerly, like Corpus. 

FACEBOOK FROM DOCUMENTED SAN ANTONIA ICU NURSE (and sounds like a damn good one — and so very brave:

https://www.facebook.com/1263124939/posts/10221743609000466/?d=n

Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? (Sent to me with instructions to use by the Norweigan girl who does the cooking, cleaning, sweeping, shopping, driving, gardening, worrying, and praying. The lucky girl has had this job for the last 54 years).

What do you call an alligator in a vest? An investigator.

If anyone gets a message from me about canned meat, don’t open it. It’s SPAM

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June 25, 2020

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June 23, 2020

James Harris	9:38 AM (6 hours ago)
to Harris

 

 

 

State hospitalizations set a record for 11th straight day; Gregg County virus cases up by 5

Five of those new cases came from Gregg County, and three each came from Harrison and Panola counties on Monday, while Smith County added 38 new COVID-19 cases over the weekend.

J. HARRIS: I added San Antonio to this list since they are now in trouble. Houston and state totals are worrisome. Our area is doing relatively well. Keep wearing your masks. 

 

JOHNS HOPKINS’ NEWS RELEASES AND REFERENCES RECENTLY:

1. Covid-19 is Threatening the Survival of US Primary Care (BMJ) This is an especially difficult time to be a GP, internist, paediatrician, or other physician providing primary care in the US. “To be honest, independent primary care was struggling long before this pandemic came along,” primary care provider (PCP) Leto Quarles wrote on the popular MedPage Today blog KevinMD. But it’s recently become much worse. Since the pandemic hit, “revenues are way down and the bills that I can’t pay are piling up,” Quarles wrote.

 

2. Chinese study: Antibodies in COVID-19 Patients Fade Quickly (CIDRAP) A new study from China showed that antibodies faded quickly in both asymptomatic and symptomatic COVID-19 patients during convalescence, raising questions about whether the illness leads to any lasting immunity to the virus afterward.

 

3. Public Attitudes, Behaviors, and Beliefs Related to COVID-19, Stay-at-Home Orders, Nonessential Business Closures, and Public Health Guidance — United States, New York City, and Los Angeles, May 5–12, 2020. During May 5–12, 2020, a survey among adults in New York City and Los Angeles and broadly across the United States found widespread support of stay-at-home orders and nonessential business closures and high degree of adherence to COVID-19 mitigation guidelines. Most respondents reported that they would feel unsafe if restrictions were lifted at the time of the survey. (CDC MMWR, 6/19/20)

 

4. PRESS RELEASE

HHS Awards $107.2 Million to Grow and Train the Health Workforce. Today, the US Department of Health and Human Services, through the Health Resources and Services Administration, is announcing awards totaling $107.2 million to 310 recipients to increase the health workforce in rural and underserved communities. Recipients across 45 states and U.S territories received funding to improve the quality, distribution and diversity of health professionals serving across the country. (HHS, 6/18/20)

 

What to know about the coronavirus and summertime activities 

Another excellent guide with what seems to be good advice about upcoming holidays and travel.  (J. Harris)

 

How to Make Cloth Face Coverings(FROM THE CDC)

J. Harris: How to do it with good simple instructions, if you can sew.

 

 

AstraZeneca Aims for 30 Million Doses of COVID-19 Vaccine for U.K. by September

 

 So what if I don’t know what apocalypse means? It’s not the end of the world!

 

    

 

 

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June 22, 2020

James Harris	7:56 AM (4 hours ago)
to Harris

 

 

 

Texas again sets 1-day COVID-19 record

“… Harrison County Judge Chad Sims said his county has three new COVID-19 case, raising the total there to 272. Harrison County has seen 26 deaths, 181 recoveries and has 66 active cases.”

In Gregg County, County Health Administrator A.J. Harris reported no new cases, keeping the total at 308.

 

J. HARRIS: Current quotations from a Houston area Board Certified Internist whom I know and trust and also the physician who alerted me to the fact that  the number or  census of patients hospitalized in various areas is likely the most important statistic that needs to be followed:    

 

     1. “The R value needs to stop being discussed as people are fantastically ignoring the incredible amount and (good) effect of six feet and a mask. Early, before six feet and a mask, the R was closer to three and THAT tells us about this bug–it is transmissible as hell. The proximity to one adds to the illusion when it really is just a report card on how well we are six feet-masking. A proper R would approach zero.

     2. After reading travel post yesterday, 21 June: “flying is stupid if the anecdotal experience of my practice counts–five of my six cases came from flights….travel by car, use Dome shaped-95 masks, keep six feet, of distance from others, drive toward destinations with  LESS COVID activity, not to vacation hot spots crawling with disease. If you do these things, travel can be almost safe.”

    3. ” I agree on six feet and a mask in general and I am ready to add best find a dome-shaped N-95 as shortages to medicos is not the rule anymore and dome works better than “duckbill” that comes out with a sharp angle to it.” 

 

******

 

Contact tracing in NYC is off to a slow start (NYT not linked)

In lieu of a vaccine, contact tracing is one of the few tools that public health officials have to fight Covid-19, along with widespread testing and isolation of those exposed to the coronavirus. The stumbles in New York’s program raise fresh concerns about the difficulties in preventing a second surge of the outbreak in the city, which is to enter a new phase of its reopening on Monday. (People don’t answer their phones)

 

 

Bullfighting, already in decline in Spain, is battered by the lockdown.

 

Mary Mallon (1869-1938) and the history of typhoid fever

Short interesting read about “Typhoid Mary” and some of the first tracking by health officials. 

 

People Have Stopped Going to the Doctor. Most Seem Just Fine.

People Have Stopped Going to the Doctor. Most Seem Just Fine.

 

Good pun? … .She had a photographic memory, but never developed it.

 

 

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