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.

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.

CDC Health Advisory Warning Against Using Ivermectin for COVID-19

I’ve seen a few warnings including the CDC Health Advisory issued August 26, 2021, against using Ivermectin in COVID-19. Ivermectin is a prescription drug used to treat parasitic infections in farm animals and humans. There’s no credible evidence supporting the use of Ivermectin to treat COVID-19 in humans and its use is currently restricted to research trials.

There have been calls to poison control centers across the country from people who suffer side effects, which can include nausea and vomiting, seizures, confusion, hallucinations and more from ingesting animal grade Ivermectin. It can cause death. Certain politicians and doctors are recommending and prescribing it for humans. At least one person has been hospitalized for treatment of side effects.

I saw the FDA warning tweet quote: “You are not a horse; you are not a cow; Seriously y’all. Stop it.” I’m not sure if that was from an FDA official, mostly because I doubt that the word “y’all” would be standard usage for FDA announcements. In any case, the FDA strongly advises against using Ivermectin to either prevent or treat COVID-19.

Merck, the manufacturer of the agent, warns against it as well.

Most of the headlines I’d seen until today were connected to Mississippi and Texas. This morning, I saw a story revealing that Iowans are also buying Ivermectin in animal supply stores, probably to self-treat or prevent COVID-19. One customer claimed it was safe for humans, purchased the product and left the store.

Nobody’s going to tackle a customer who insists on using Ivermectin in a misguided effort to treat COVID-19. There’s no law against it, so nobody’s going to call the police to intervene.

There’s a song titled “Iowa Stubborn” from the Music Man, a show starring Meredith Willson, who was from Iowa. I’m hoping the “chip-on-the-shoulder attitude” will eventually lead Iowans toward making the common-sense, community minded decisions (for which we are also known) that will eventually free us from the grip of the pandemic.

In times like these, I wonder—what would Chet Randolph think?