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.

The COVID-19 Delta Variant

I’m passing along the University of Iowa Hospitals & Clinics information about the Delta variant of COVID-19. If you’re vaccinated and you get infected with the Delta variant, you might feel like your symptoms are from allergies or a cold. If you’re not vaccinated, you’re a lot more likely to get sick enough to be hospitalized.

According to Dr. Claudia Corwin, MD, MPH, an occupational medicine specialist and associate director of the University Employee Health Clinic, about 97% of those with a severe case of Delta variant are unvaccinated. That doesn’t mean the vaccines make us bullet proof and breakthrough infections of the Delta variant occur.

That’s probably part of the reason why the Advisory Committee on Immunization Practices (ACIP) thinks vaccine booster shots might be better reserved for the most vulnerable patients, such as the very elderly, those in Long Term Care Facilities, and health professionals. The ACIP met yesterday and there was no firm decision about booster rollout specifics and there was no vote on the matter. They plan to meet again in mid-September to review the need for boosters.

Advisory Committee On Immunization Practices Meeting On Boosters Today

Judging from the slides in Dr. Sarah Oliver’s presentation, “Framework for booster doses of COVID-19 vaccines” in the ACIP meeting this afternoon, there is limited data to support COVID-19 vaccine boosters for the general population at this time. The target populations for boosters would be the residents of Long Term Care Facilities (LTCF), health professionals, and those over 65 and 75 years of age, although the goal of ensuring that as many unvaccinated individuals get vaccinated should be actively pursued. There will continue to be further meetings to discuss the role of boosters.

The Iowa City Mask Mandate

The mask and vaccine mandates for COVID-19 have been in the news a lot and there has been plenty of controversy about them, which is putting it mildly. I’ve been thinking about the mask mandate that Iowa City Mayor Bruce Teague issued August 19, 2021 and scheduled to expire on September 30, 2021. I agree with it, just to get that out of the way. Johnson County is a high transmission area for the virus, as is most of the state of Iowa, according to the CDC’s COVID Data Tracker. Hospitalizations and deaths are increasing from COVID-19 infections. The CDC recommendations and rationale for interventions to control the spread of the virus make sense to me.

On the other hand, Iowa Attorney General Tom Miller is investigating whether or not the mandate is legal based on the conflict with the Iowa law passed in May 2021 by Governor Kim Reynolds. It’s sort of an anti-mandate similar to others I’ve seen in the news. I think it’s based on the state law which says that municipalities cannot adopt an ordinance requiring an owner of real property to implement a policy relating to the use of facial coverings that is more stringent than the state’s policy.

I have no idea what the difference is between persons who are owners of real property and persons who are just plain individuals. I thought they were the same—unless you consider homelessness an important factor. Would that make someone who is homeless a non-person? Just because they’re often treated that way is beside the point—isn’t it? I’m just kidding, sort of; it looks like the owners of real property might be understood as business owners and the like. And everyone knows they’re not real people.

Does Mayor Teague’s mandate apply to the University of Iowa? Not if you believe that the virus expressly avoids University of Iowa property; so at least that’s settled. The sticking point is that the Iowa Board of Regents and the Governor are the authorities over what happens on state-supported university property, unless it’s connected to beer.

AG Miller has plenty of time to consider the matter because there is no provision for enforcement of Mayor Teague’s mask mandate. By the way, the city of Coralville also has a mask mandate that was issued by Coralville Mayor John Lundell, effective August 11, 2021. I don’t know if Mayor Lundell’s mandate provides for enforcement if it’s not followed, but I suspect it isn’t. I’m not sure why AG Miller is not investigating Mayor Lundell’s order to see that it’s legal or not. I thought we were an equal opportunity state. University Heights has not had a mask mandate since August 18, 2020, unless there’s a typo on their website.

Many people are not aware that Coralville, Iowa City, and University Heights are separate municipalities. If you blink, you might miss the transitions between them.

I’m not sure how you’d enforce the mandate. I’m pretty sure police are not going to tackle you and secure a mask to your face using a county-approved staple gun. I’m also wondering what legal consequences there could be if AG Miller finds that Mayor Teague’s mandate is illegal, especially since it’s unenforceable.

I’m not sure what you can do to enforce such mandates or anti-mandates. Without enforcement, the mask mandate is a strong recommendation. In addition to the science, it has little more than common sense to back it up, although common sense is not commonly used.

You wonder how aliens (who are almost always idealized as being very advanced and superior to earthlings) would look at this situation and what they would do about it to help the human race. I’m reminded of what Agent K says to Agent J in Men in Black (MIB) as he shows Agent J a universal translator (one of the many gadgets MIB holds patents on, making them independent of governmental oversight): “We’re not even supposed to have it. I’ll tell you why. Human thought is so primitive it’s looked upon as an infectious disease in some of the better galaxies.”

Maybe aliens are vaccinated against us.

Reminisce Once in a While

Occasionally I’ll reminisce, an activity which recently got triggered when I realized why I tend to like watching TV shows like Highway Thru Hell and Heavy Rescue 401, which are heading into the 10th and 6th seasons, respectively. Despite that, last year I didn’t see any episodes in which the COVID-19 pandemic was even mentioned. Nobody wears masks. They’re hard-working people in Canada who basically drag semi-trucks out of various ditches. It’s hard work, they’re down-to-earth and they’re not acting.

I marvel at what they do. It’s brutal, real, and no-nonsense. While I watch them, I tend to forget about the pandemic, and the social and economic upheaval everywhere on the planet. For a little while, I almost stop thinking about bored I am and without a purpose or meaning sometimes in retirement. I just find myself being glad I don’t have their job.

Sometimes I think about how I got my start as a working stiff, starting out as a teenager doing practical work like the heavy tow truck drivers. Now, don’t get me wrong. I’m not trying to sell you the idea that land surveying is really hard work. I was outside most of the time, although in the winter when highway, street, and other construction was down, I would do some drafting. I worked for WHKS & Co. If you click the link to their website, scroll all the way down on the About Us section. There’s a black and white picture with four frowning men sitting at a heavy desk in front of a bookcase with many large books in it. They are from left to right, Richard “Dick” Kastler, Francis Holland, Ralph Wallace, and Frank Schmitz. I didn’t know Richard but his brother, Carol Kastler, was my boss along with the other three. Carol Kastler was the head of the land surveying department.

This is not going to be a history of surveying, which I’m not qualified to do; just my impressions of it as a young man. I can flesh it out a little with a video about how to throw a chain, and an extremely detailed reminiscence written by a real old-timer about surveying that was a lot like the way I remember it. Try to read all of Knud E. Hermansen’s first essay about measuring with a steel tape, “Reminisce Of An Old Surveyor, Part I: Measuring a Distance by Taping.” You can skip Part II, which even I couldn’t relate to because the stuff was way before my time.

Hermansen’s description of measuring distance using a steel tape and plumb bob is spot on, though. The other thing I would do in the winter down time was tie up red heads—which is not what you’re thinking. You tied red flagging around nails which were used to mark distances measured.

We often did work out in the field through the winter, though. When we set survey corners using what were called survey pins. Sometimes we had to break through the frozen ground first by pounding a frost pin with a sledge hammer. I remember WHKS & Co. made their own cornerstones using a wood frame box and cement. They were several feet long and they were heavy and surveyors carried them slung to their backs through the timber.

We spent a lot of cold days on straightening out a lot of the curves in Highway 13 between Strawberry Point and Elkader in eastern Iowa. We had expense accounts and were often away from our homes a week at a time for most of the winter. We ate a lot of restaurant food. Carol Kastler was partial to pea salad.

Guys told colorful stories out in the field, some of them pretty sobering. We were out setting stakes for widening a drainage ditch and talking with an old timer running a piece of heavy equipment called a dragline excavator. It has a long boom and a bucket pulled by a cable. The old timer told a harrowing study about his son, a dragline operator himself, who suffered a terrible accident. Somehow the boom broke off and fell on him. It didn’t outright kill him and workers frantically called his father (the old timer). They told him to come quick to see his son before he died because they knew they couldn’t get him to a hospital quick enough from way out in the field. The old timer just said, “I don’t want to see him.” It was just like that, a simple statement. It sounded cold but he somehow conveyed that he just didn’t want his last encounter with his son to be under a horrifying circumstance like that.

The company had Christmas parties which almost everybody enjoyed a lot. There were some guys who had a hard time relaxing. I remember a driven, work-devoted surveyor, who was thinking about work. I could tell because there was some kind of game we were playing which involved writing something like a question on a piece of paper and giving it to someone else, some inane thing like that, I can’t remember the details. I gave him my slip, and he took it. While he scribbled something on it without looking at it, he looked away and mumbled, “I really don’t have a whole lot of time.” He was at the party but his mind was out in the field.

It’s hard not to absorb experiences like that early in your life when you’re still young and impressionable. Work can become a way of life. It doesn’t seem to make a difference what kind of work it is. Even Agent J in Men In Black 2 gets a short lecture from Zed after Agent J returns from a mission and seems like he’s on autopilot, asking Zed for yet another mission, “What do you got for me?” Zed says, “Dedication’s one thing, but this job will eat you up and spit you out.”

It’s even hard for some of the guys in Highway Thru Hell and Heavy Rescue 410 to relax; even after a heart attack, one older guy can’t wait to get back in the tow truck. But even he knows that it’s a young man’s job.

Anyway, I promised I would show a video about how to throw a chain, which I learned how to do back in the day. I’m pretty sure I couldn’t do it today.