Try to Keep Up with the COVID-19 News (Good Luck)

Things are happening fast all around the country and in Iowa when it comes to news about the COVID-19 vaccine boosters and mask mandates.

It looks like the Iowa ban on mask mandates for public schools will be on temporary hold by a Federal restraining order for now according to a news item from the Daily Iowan. A mask mandate is being planned by the Iowa City Community School District.

The watchword on COVID-19 vaccine boosters is “wait and see” according to a few scientists. Some of them are saying there is not enough data yet to support the need for boosters. I hope the link to this full text Lancet works. If it doesn’t work, try this link to see the article at ScienceDirect.

Central Iowa clinics as well as the University of Iowa Hospitals & Clinics (UIHC) seem ready to start boosting (Pfizer only for now) as soon as next week. UIHC has a notice on the Loop about it (they also mention the Federal vaccine mandate which could apply to them). Story County is just waiting for the word “go” from the Iowa Department of Public Health (IDPH). Everybody seems confident that the FDA will green light boosters this Friday after the Advisory Committee meeting.

There must be some kind of hot line between the IDPH and the FDA–and the CDC Advisory Committee on Immunization Practices (ACIP) as well because I thought they had to weigh in on the issue too. It seemed like ACIP had made their opinion pretty clear; they didn’t think it was necessary at the August 30, 2021 meeting that boosters were necessary for the general public. They did think boosters for the residents of Long Term Care Facilities, health care professionals, and the elderly could be warranted.

The CDC has updated information about boosters. Basically the ball goes to the FDA and the ACIP. The CDC has also posted more recent articles on their website that tend to support the continued efficacy of the current vaccines:

Scobie HM, Johnson AG, Suthar AB, et al. Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021. MMWR Morb Mortal Wkly Rep. ePub: 10 September 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7037e1external icon.

Grannis SJ, Rowley EA, Ong TC, et al. Interim Estimates of COVID-19 Vaccine Effectiveness Against COVID-19–Associated Emergency Department or Urgent Care Clinic Encounters and Hospitalizations Among Adults During SARS-CoV-2 B.1.617.2 (Delta) Variant Predominance — Nine States, June–August 2021. MMWR Morb Mortal Wkly Rep. ePub: 10 September 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7037e2external icon.

Bajema KL, Dahl RM, Prill MM, et al. Effectiveness of COVID-19 mRNA Vaccines Against COVID-19–Associated Hospitalization — Five Veterans Affairs Medical Centers, United States, February 1–August 6, 2021. MMWR Morb Mortal Wkly Rep. ePub: 10 September 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7037e3external icon.

The situation is changing rapidly. I’ve read that the ACIP might hold a meeting on boosters on Saturday after the FDA this Friday. So far I don’t see it on the ACIP schedule. The one on September 29, 2021 is not about COVID-19 vaccine boosters.

The Monsters

Sena and I got our annual flu shots last week, and I also got a pneumonia vaccine. We’ve been fully vaccinated against COVID-19 since earlier in the year. Now we’re waiting for the word on whether we’ll need COVID-19 vaccine boosters. We’ll probably know more about that by the end of the week after the FDA Advisory Committee meeting on the matter.

We’re part of the vaccinated, which is increasingly distinguished from the unvaccinated in various ways. The controversy about the unvaccinated almost amounts to them being discriminated against, according to some news headlines. The COVID-19 pandemic is now being called a pandemic of the unvaccinated, although some are able to resist the trend by seeing through it and realize we’re all in this together.

It reminds me of an old Cold War era episode of The Twilight Zone, “The Monsters Are Due on Maple Street,” which originally aired in 1960. The gist is that aliens seeking to conquer earthlings create paranoia and violent conflict amongst neighbors on a quiet cul-de-sac simply by manipulating the electrical power to cars and other devices. At first, the electrical malfunctions are only puzzling until a boy named Tommy tells everyone that the trouble is being perpetrated by aliens who are indistinguishable from humans, a notion he got from a comic book.

And after that, everyone on the street begins accusing each other of being malevolent aliens disguised as humans, often on the basis of interpreting benign behaviors like insomnia or tinkering with a ham radio as evidence for dangerous plots. One character even shoots his neighbor dead, believing he’s a dangerous alien.

There was a 2003 remake of this in which the government, instead of aliens, is doing the manipulating. No doubt both of these will be re-broadcast as part of Twilight Zone marathons next month as part of the usual October Halloween TV program lineup.

Sena thought of another Twilight Zone show, “The Shelter,” first broadcast in 1961, which also might fit the current pandemic context. A doctor builds a bomb shelter to protect just him and his family in case of a disaster. The unthinkable happens with UFOs being sighted and the friends and neighbors who threw a party for him all want to beg, bargain, or threaten their way into the doctor’s bomb shelter because they didn’t build their own. He refuses to allow them in. The neighbors turn on each other, showing the worst selfishness, hatred, and racism. They finally break into the doctor’s shelter with a battering ram (which, of course, negates the safety it might have provided)—only to find out in that moment that the UFOs were just satellites. They had become monsters and could not see how it happened.

Depending on what news media outlet you prefer to read, the vaccinated or the unvaccinated will be cast as bad guys or good guys. As the rhetoric heats up based on divisions between political parties, religious groups, scientists, races, and nations, the antipathy has fostered escalating tensions over whether vaccine and mask mandates should or should not prevail. The unvaccinated have their own battering ram—fake vaccination passports, which negate the safety assurance. The unvaccinated can’t get in to see their doctors in person, poison themselves with unproven medicines, or accuse the government of trying to poison them with vaccines. The wealthy vaccinated buy their booster shots at the expense of those who can’t afford them and before the medical experts can approve their safety and necessity. People are resorting to violence.

I always had a little trouble with the title of the Twilight Zone episode, “The Monsters Are Due on Maple Street.” The monsters are not just due—we have arrived. Why is it so hard for me to recall an episode showing exactly how to recover our humanity?

FDA Advisory Meeting on Pfizer COVID-19 Vaccine Booster Announcement

The FDA announcement about the Advisory Committee meeting on the Pfizer COVID-19 vaccine booster for September 17, 2021 is here. The time will be 8:30 AM-3:45 PM ET (check your time zone provided on the FDA YouTube web page). Review materials (if available) will be posted at the FDA link provided in the announcement.

Pelican on the Lake

Sena and I went for a walk on the Terry Trueblood Trail yesterday. We saw a huge apple tree on the trail. We’ve never noticed it before. The boughs were bent and broken from the load of apples. There were a lot of buzzing insects, maybe some annual cicadas among them.

We saw a lone American White Pelican on the lake, the first one we’ve ever seen.  There were no other birds on the water. In fact, we didn’t notice other birds other than the pelican. All but one of the tree swallow nest boxes had been removed. Nothing peeked out from it.

The pelican just bobbed about on the lake. They migrate in autumn to Central and South Americas. They’re often seen in large groups, but this one was alone. They get pretty big, about 5 feet tall, and can have a 9-foot wingspan.

Pelicans are often connected to symbolic meanings including nurturing, humility, charity, healing, wisdom, and sacrifice.

Where were all the other pelicans?

Comirnaty vs Comiranty Spelling Bee Issue Resolved

This is just an update on the Pfizer-BioNTech COVID-19 vaccine Comirnaty vs Comiranty spelling issue at UIHC, which has been resolved today. It took a few emails to get it fixed. I was beginning to think I was losing my mind and that I was the only who could see the mistake. Comirnaty had apparently been misspelled as Comiranty on several web pages for maybe a couple of weeks.

You can just look at the word Comirnaty and see how this could have happened. Looking at it in print makes me think there are two letter “m’s” in it. Transposing the two letters “a” and “n” looks easy to do. There are a few anagrams web sites that are picking up on the word Comirnaty. I kind of like “try anomic.” Can you really get “community,” “immunity,” and “mRNA” out of that agglomeration? Maybe. It’s a name game.

I could chalk this up to just me being a retired guy with too much time on his hands and nitpicking. On the other hand, there is that story about a typo ending World War II. In all fairness, there is some doubt about the accuracy of it. But it’s fascinating to think that the difference in spelling between cryptogamist (someone who studies algae) and cryptogramist (someone who studies codebreaking) might have made all the difference in the war’s outcome.

Comirnaty Misspelled by the Medical Community

This afternoon I just notified somebody at the University of Iowa Hospitals & Clinics (UIHC) that the Pfizer COVID-19 vaccine’s name is misspelled on several of their web pages. The new name for the vaccine is Comirnaty (pronounced koe-mir-na-tee). UIHC misspells it as “Comiranty.” And it has been that way for at least a week, probably since Pfizer publicly announced the name after the vaccine was fully licensed by the FDA. I found three instances of that although there could be more.

I found a news item that explains the name was deliberately chosen in order to remind us of the word “community” and the “mRNA” technology of the vaccine.

It actually reminded me of Foster Brooks whose comedy routine consisted of acting like he was drunk, slurring his speech in a parody of intoxication. The only way “Comirnaty” can make you think of “community” is if you’ve had a few too many.

On the other hand, “Comiranty” makes me think of the one Indiana Hoosier football player who was caught on camera with the word Indiana misspelled as “Indinia” on his jersey yesterday. By the way, Iowa beat Indinia 34-6 in the season opener. In all fairness, Indiana is not the only state that struggles with spelling.

Update on COVID-19 Vaccine Boosters

The messaging on COVID-19 boosters is being clarified by the CDC and the FDA in separate announcements, posted September 1, 2021.

The CDC update is here. The FDA announcement is here. The FDA plans to hold a virtual meeting about the issue September 17, 2021 from 8:30 AM to 3:45 PM EST and it will be livestreamed on the agency’s YouTube channel. Background material will be made available to the public two days before the meeting.

“Those who are tardy do not get fruit cup.”

Love Each Other More Now

When I think about all the mandates and bans against mandates for the COVID-19 vaccines and masks, I wonder about my own motive for getting the vaccine and wearing a mask.

In one sense, I’m doing it for myself. I’m a retired consultation-liaison psychiatrist and I got called to the intensive care units a lot. Almost always, the patient was delirious. And almost always, the patient was delirious in the setting of being on the ventilator or in the process of being liberated from the ventilator.

The critical care physician and the nurses were always looking for one specific thing from me. I was supposed to stop the patient from being agitated, to calm the wildly thrashing, terrified person fighting the restraints and struggling with hallucinations and fragmented paranoid delusions that every caregiver in the unit was trying to kill him. Often there were many medical problems, including multiple organ failure often from lack of oxygen, resulting in brain injury as well. Nowadays, COVID-19 is a frequent cause of delirium for the same reasons.

Years ago, the only tool I had was an antipsychotic called haloperidol, because it could be given intravenously. It would calm some patients, but it could and did cause side effects including akathisia (extreme restlessness), dystonia (severe muscle spasms), and neuroleptic malignant syndrome NMS, a rare, complex, life-threatening neurologic emergency attributable to antipsychotics. Over the past several years, the ICU pharmacies acquired newer drugs like dexmedetomidine, which is not a psychiatric drug. That didn’t stop the ICU from calling me.

I’ve seen all of that. I got the vaccine and wear the mask mostly because I don’t want to be in that boat. But I think those measures help protect others, too. I think many people have that motive. Those who think they’re getting it just for themselves can go on thinking that.

We’re taking a risk when we get the vaccine. It’s not completely harmless. There are very rare side effects which can be life-threatening and they have killed people. There is some level of altruism involved. Those who get the vaccine are playing a role, however small, in reducing the chance the virus will mutate into something that will kill even more people.

Wearing masks is a nuisance and doesn’t really feel heroic. But this act combined with other measures (the usual suspects: hand-washing, social distancing, avoiding large crowds) spreads love instead of infection.

We don’t have to agree. We don’t have to love each other. I just hope we can respect each other.