How Many Might Die Even With a COVID Vaccine?

https://www.medpagetoday.com/infectiousdisease/covid19/89918

On July 16, 1945, the U.S. performed the first atomic bomb test in New Mexico. As the blast wave reached Enrico Fermi, the noted physicist and inventor of the world’s first nuclear reactor, who was among those watching the explosion some 10 miles away, he dropped bits of paper in order to see how far they would be blown. Fermi reasoned that the distance traveled by the paper could be used to make a quick calculation of the bomb energy yield.

His estimation was 10 kilotons of TNT. The actual energy of the blast was 18.6 kilotons of TNT.

Fermi’s quick calculation was within an order of magnitude and therefore within the mathematics of such things. His estimate was impressive. Fermi was famous for many things, but his bits-of-paper trick cemented his fame in what is now referred to as a back-of-the-envelope calculation: the use of estimated or rounded numbers to make rapid ballpark calculations, usually done on a scrap of paper like the back of an envelope.

Americans consistently score low on tests for mathematics. Most Americans consider themselves bad at math and nearly one in five adults suffer from high levels of math anxiety. This is a particularly bad time to be bad at math as we try to make sense of numbers about infection and death by COVID-19.

What Fermi understood is that the real test of math aptitude is the ability to logically estimate. The trick is to break down a seemingly complex equation into smaller parts where the number becomes manageable and relatable.

This is particularly important when the number is really big or really small. What Fermi was actually contemplating with falling bits of paper was the number of people that the bomb would kill.

Recently, Pfizer announced it had a vaccine that is looking like it will be 95% effective against COVID-19. Pfizer, like Fermi, is also thinking about death.

Sometimes an estimation needs a little more background and an understanding of what is at stake. Census data from 2019 estimated the U.S. population at 328.2 million people. We know that about 10 million people in the U.S. have so far contracted COVID and we will assume that prior infections confer immunity and those individuals will not be vaccinated. We can now work with the total population uninfected and unvaccinated to be 318.2 million people.

Many people have said they would refuse a COVID vaccine, and this position, known as vaccine hesitancy, makes it difficult to predict how many people would actually accept a COVID vaccine. For DTP (diphtheria, tetanus, pertussis), a required vaccine, the vaccine rate was 83% of the target population. Polio vaccine uptake was 92.7%. These are long-standing and generally well-accepted vaccines, but for other equally effective vaccines, the vaccine acceptance rate is actually falling.

Let’s assume a relatively high rate of 80% uptake for a new COVID vaccine. This means 20% of 318 million people won’t get vaccinated — about 64 million people. Recall that the Pfizer vaccine is claimed to be 95% effective, so 5% of the vaccinated population will get no benefit and will still be at risk for catching COVID-19. The number of the original vaccinated population that will get no benefit is 13 million and when we add this to 64 million unvaccinated people, we get 77 million people.

COVID-19 does not kill everyone who becomes infected. The amount of killing is called the infection fatality rate and for COVID-19, that number has been estimated to be 0.65%, but may be as high as 2%. If every unvaccinated or ineffectively vaccinated person still got COVID-19, the number of Americans that would still die would range from 500,000 to two million — and that’s with a vaccine that is 95% effective.

To put that into perspective, that means COVID-19 would kill the equivalent of every single person in a city the size of Tampa, Miami, Long Beach, or Minneapolis — or even in a city as large as Phoenix, San Diego, or Philadelphia.

We have left off important information from our back-of-the-envelope equation: How long will it take to vaccinate 254 million people? How long will it take to make enough vaccine doses for 254 million people?

In 1972, smallpox was considered eradicated in Europe. In March of that year, the former country of Yugoslavia suffered an outbreak. The government sprang into action and reacted swiftly. On March 16, 1972, martial law was declared, population movement was severely restricted, and in effect, the entire country was placed under quarantine. The army was used to enforce the quarantine and over a period of approximately 3 months, the entire population of 18 million was vaccinated and the outbreak ended.

Of course, 18 million is a much smaller number than 254 million and I doubt Americans would look kindly on the imposition of martial law for months and months while we carry out vaccinations. As a result, we can expect that our back-of-the-envelope calculation, which assumes mass, instantaneous vaccination, actually underestimates the number of people still vulnerable to COVID-19.

There are other complications: Moderna’s and Pfizer’s vaccines use mRNA technology, which requires very cold storage with dry ice. We now learn that although the toilet paper shortage is under control, the dry ice shortage is getting worse. Moderna claims its mRNA vaccine only needs more conventional freezer and refrigeration temperatures.

To produce the needed quantity of vaccines is no small feat and might require a level of commitment that up until now we have failed to achieve.

We must also consider who will benefit from this vaccine aside from those whose lives are saved. It was recently reported that Pfizer CEO Albert Bourla sold 62% of his stock in the company on the same day the company announced the results of its COVID-19 vaccine trial. The value of his stock sell-off was about $5.6 million earned in a single day. Others in the company also sold stock and earned millions of dollars.

In 2018, the median individual income in the U.S. was $33,706 per year. It would take that person with that income about 169 years to earn $5.6 million dollars.

The lived reality of COVID-19 is that it has become a new cause of premature death. To get a sense of how many Americans have died so far from COVID-19, you would need to add up all the American deaths in the Korean War, the Vietnam War, and the Iraq and Afghanistan Wars, as well as the number of people killed annually in car accidents and by firearms, as well as the number of people killed annually by the flu.

A 95% effective vaccine will likely reduce the number of people killed by COVID-19, but that will not be nearly enough to bring death by COVID-19 to a halt. In order to do that, we will likely need a plan of action far beyond what to this point we have been willing to do.

The announcement of the development of 95% effective vaccines is good news, but it is no cause for celebration. Even with a perfect, instantaneous rollout, hundreds of thousands of people would continue to die.

At the end of the day, the real tragedy might be how little we did for so long and how we can abide 260,000 deaths in this country so far and not really feel it.

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Canada bans mass exports of prescription drugs

https://www.bbc.com/news/world-us-canada-55119428

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https://www.youtube.com/watch?v=t75xvZ3osFg

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https://youtu.be/5-qyFLHwIs0

See previous you tubes on Covid 19 we have a national health car crisis with people believing masks are the answer when the truth masks only are the first part of control, second and most importantly are HANDS and direct spread

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More people are getting COVID-19 twice, suggesting immunity wanes quickly in some

https://www.sciencemag.org/news/2020/11/more-people-are-getting-covid-19-twice-suggesting-immunity-wanes-quickly-some

Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

In late June, Sanne de Jong developed nausea, shortness of breath, sore muscles, and a runny nose. At first, she thought it might be lingering effects from her COVID-19 infection in the spring. De Jong, 22, had tested positive on 17 April and suffered mild symptoms for about 2 weeks. She tested negative on 2 May—just in time to say farewell to her dying grandmother—and returned to work as a nursing intern in a hospital in Rotterdam, the Netherlands.

But when her symptoms re-emerged, her doctor suggested she get tested again. “A reinfection this soon would be peculiar, but not impossible,” she told De Jong, who by then had again lost her sense of smell and had abdominal pains and diarrhea.

The call from her municipal health service came on 3 July. De Jong had tested positive again. “You’re kidding me!” she recalls saying.

Scientists are keenly interested in cases like hers, which are still rare but on the rise. Reinfections hint that immunity against COVID-19 may be fragile and wane relatively quickly, with implications not just for the risks facing recovered patients, but also for how long future vaccines might protect people. “The question everybody wants to answer is: Is that second one going to be less severe most of the time or not?” says Derek Cummings, who studies infectious disease dynamics at the University of Florida. “And what do reinfections teach us about SARS-CoV-2 immunity in general?”

South Korean scientists reported the first suspected reinfections in April, but it took until 24 August before a case was officially confirmed: a 33-year-old man who was treated at a Hong Kong hospital for a mild case in March and who tested positive again at the Hong Kong airport on 15 August after returning from a trip to Spain. Since then, at least 24 other reinfections have been officially confirmed—but scientists say that is definitely an underestimate.

To count as a case of reinfection, a patient must have had a positive polymerase chain reaction (PCR) test twice with at least one symptom-free month in between. But virologist Chantal Reusken of the Dutch National Institute for Public Health and the Environment (RIVM) explains that a second test can also be positive because the patient has a residue of nonreplicating viral RNA from their original infection in their respiratory tract, because of an infection with two viruses at the same time or because they had suppressed but never fully cleared the virus. So most journals want to see two full virus sequences, from the first and second illnesses, that are sufficiently different, says Paul Moss, a hematologist at the University of Birmingham. “The bar is very high,” Moss says. “In many cases, the genetic material just isn’t there.”

Even if it is, many labs don’t have the time or money to clinch the case. As a result, the number of genetically proven reinfections is orders of magnitude lower than that of suspected reinfections. The Netherlands alone has 50 such cases, Brazil 95, Sweden 150, Mexico 285, and Qatar at least 243.

The Hong Kong patient’s second infection was milder than the first, which is what immunologists would expect, because the first infection typically generates some immunity. That may explain why reinfections are still relatively rare, says Maria Elena Bottazzi, a molecular virologist at Baylor College of Medicine and Texas Children’s Hospital.

They could become more common over the next couple of months if early cases begin to lose their immunity. Reinfections with the four coronaviruses that cause the common cold occur after an average of 12 months, a team led by virologist Lia van der Hoek at Amsterdam University Medical Center recently showed. Van der Hoek thinks COVID-19 may follow that pattern: “I think we’d better prepare for a wave of reinfections over the coming months.” That’s “bad news for those who still believe in herd immunity through natural infections,” she adds, and a worrisome sign for vaccines.

Others are less pessimistic. Although antibodies can wane substantially within months—particularly in patients with less severe disease—they sometimes persist, even in mild cases. Neutralizing antibodies, the most important kind, as well as memory B cells and T cells seem to be relatively stable over at least 6 months, a preprint posted on 16 November shows, which “would likely prevent the vast majority of people from getting hospitalized disease, severe disease, for many years,” lead author Shane Crotty of the La Jolla Institute for Immunology told The New York Times.

And there are hints that people who have serious COVID-19 mount the strongest responses, just as in the two other serious human diseases caused by coronaviruses, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome. Both trigger high antibody levels that last up to 2 years, and T cell responses to SARS can be detected even longer. Because of these persistent immune defenses, “I expect that most reinfections will be asymptomatic,” says Antonio Bertoletti, an infectious disease specialist at the National University of Singapore. He says being reinfected might even be a good thing, “since you will continue to boost and train your immune system.”

Not all reinfections seen so far are milder. “We see all different combinations,” Reusken says. The second time Luciana Ribeiro, a surgeon in Rio de Janeiro, got sick, it was much worse. She was first infected by a colleague in March, developed mild symptoms, and tested negative afterward. Three months later, Ribeiro had symptoms again—she could no longer smell her breakfast, she says—but she didn’t immediately get a test because she thought she was immune. When she grew more and more tired, she requested a computerized tomography scan. “It showed that half of my lungs were affected,” ­Ribeiro says. “‘This clearly is COVID,’ the radiologist told me. I didn’t believe it, but I tested positive.”

Ribeiro thinks she was reinfected by a patient in the intensive care unit where she works, and that her second episode may have been worse because virus-laden aerosols produced during a medical procedure entered her lungs. But she has another theory as well: “It could be that the virus has become more virulent in the meantime.”

So far, no proof exists of mutations that would make the virus more pathogenic or that might help the virus evade immunity. But a recent preprint by a team at the Swedish Medical Center in Seattle suggests one may exist. The team describes a person who was infected in March and reinfected 4 months later. The second virus had a mutation common in Europe that causes a slight change in the virus’ spike protein, which helps it break into human cells. Although symptoms were milder the second time, neutralization experiments showed antibodies elicited by the first virus did not work well against the second, the authors note, “which could have important implications for the success of vaccine programs.”

And some scientists worry about another scenario that could make the second episode worse: enhanced disease, in which a misfiring immune response to the first infection exacerbates the second one. In dengue fever, for example, antibodies to an initial infection can actually help dengue viruses of another serotype enter cells, leading to a more severe and sometimes fatal second infection. In some other diseases, the first infection triggers ineffective, nonneutralizing antibodies and T cells, hampering a more effective response the second time around.

A recent preprint published by Chinese researchers suggested patients whose first COVID-19 infection is very severe may have ineffective antibodies, which might make them more prone to severe reinfections. But so far there’s no evidence from reinfected patients to suggest enhanced disease is at work in COVID-19—although scientists haven’t ruled it out either. Vaccination against some diseases can also trigger enhancement later—a known or suspected complication of vaccines against dengue and respiratory syncytial virus in humans and a coronavirus disease in cats. But there is no evidence that candidate COVID-19 vaccines do so, Cummings says. “Having worked with dengue I can say the empirical basis for enhanced disease is just not there, while it was very strong in dengue.”

De Jong’s virus samples were both sequenced in Reusken’s lab, with a surprising outcome: The sequences were not identical, but showed so much similarity that RIVM virologist Harry Vennema says she probably did not clear the virus in April and that it started to replicate again in June. “I did have a lot of stress after that first episode because my grandmother died,” De Jong says. “Maybe that had an impact on my immune system.”

That makes her case different from a true reinfection—although Vennema says perhaps they should be considered similar, because in both cases the immune system failed to mount a protective response. His lab has found at least one similar case, he says, suggesting some unconfirmed reinfections might actually be a resurgence of the original virus.

Other coronaviruses can also cause persistent infections, says Stanley Perlman of the University of Iowa. In 2009, his team showed that an encephalitis-causing mouse coronavirus can linger in the body and continuously trigger immune responses, even if it doesn’t replicate. And in a preprint posted on 5 November, a team of U.S. scientists shows SARS-CoV-2 can persist for months inside the gut. Persistent infections, they suggest, may help explain the extraordinarily long-lasting symptoms that afflict some COVID-19 survivors.

De Jong is experiencing some of those symptoms. Although she tested negative in September and has high levels of neutralizing antibodies, suggesting she is protected for at least a couple of months, she still suffers from gastrointestinal complaints, fatigue, and cognitive impairment. De Jong says her story is a warning to people who had the virus and think they’re now invulnerable: “Please be cautious. You can get it again.”

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This chart is suppose to be from the CDC.  It indicates that only 9.2% of opiate OD’s are from pharma opiates, BUT – the title on the graph says “ILLICIT DRUGS”… so none of the OD’s from a pharma opiate alone the person DID NOT HAVE A RX FOR THE PHARMA OPIATE IN THEIR TOXICOLOGY ? There are ten columns and six columns indicated that illegal Fentanyl was found in toxicology – either the sole reason for the OD or in combination with other substances.  Those percentages add up to at least 50% of all OD’s from this group of OD’s.

Two important years to note in this graph. 2012, reportedly the year that opiate Rxing peaked and 2016 the start of the CDC guidelines.

All the lines – except the > 65 y/o shows a sharp upturn.

From 2012 to 2017 all the values more than doubled.

Does this suggest that those >65/yo continued to get at least a moderate amount of pain medication ?

What we still don’t know – either because the CDC doesn’t have the data or doesn’t share the data, if these OD’s were accidental overdoses or SUICIDES ?

Does this also suggest that illegal Fentanyl started showing up on the street as “Heroin” or the street dealers were mixing in illegal Fentanyl to increase the available supply.  Heroin has to be grown whereas illegal Fentanyl is chemical reactions and the only limits to the quantity that can be produced/obtained is obtaining the basic chemicals and space to “mix the chemicals and package the final product”.

It was claimed that Illegal Fentanyl was less expensive than Heroin and mg to mg it was at least TWELVE TIMES the potency.

Newton’s Third Law of Motion. It states, “For every action, there is an equal and opposite reaction”… so it would appear that for every action by the Federal/State bureaucracies to stop addiction and OD’s … DID JUST THE OPPOSITE

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Beaumont Cardiologist Wants Executives Fired

https://www.medpagetoday.com/publichealthpolicy/workforce/89900

Robert Safian, MD, wrote system’s board about toxic culture, pursuit of profit over people

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I do not support nor encourage someone committing suicide …BUT…. before COVID-19 we had about 50,000/yr suicides and ONE MILLION ATTEMPTS and many claim that suicides have increased since COVID-19 came around in Feb/March.

I know that I am walking out on very far on a ethical limb… but read this entire post and see if you don’t agree with the logic behind it. Recently I made the post below and the title is linked back to the post

call their bluff with a letter from attorney ?

Out of those 50,000 suicides and one million attempts is there a suicide note left behind … which contains a statement as to who is to blame for this person for exercising the “final solution ” to get themselves out their unrelenting pain ?

Look at the chart on the above post of the adverse effects to the human body of under/untreated pain and look at the very last line “INCREASED THOUGHTS OF SUICIDE”.

Following the path that is outlined in the attached post to put those on notice that is involved in reducing/stopping a pt’s pain meds… doesn’t make any difference if it is a prescriber, insurance/PBM company, chain pharmacy if the pt suffers a stroke, heart attack, death or suicide… suicide in particular, could whoever is behind the decision to cut the pt pain meds.. could them be charged with assisting suicide, involuntary manslaughter or some similar charge… Insurance/PBM companies have medical directors and one would think that is where such policies of reducing pt’s pain meds would originate… and thus would they be the one who could be personally held responsible ?

Healthcare corporations have gotten away with cutting/stopping meds because they have no fear of retribution from pts.  Putting these healthcare corporations ON NOTICE with a single certified letter from the pt’s attorney could start the ball rolling.  If someone has committed suicide and left behind a suicide note who they blame..then the pt’s relatives should be able to go to the local prosecutor or state AG and have charges/arrest warrant on the individual who the pt claim was the reason behind the pt’s actions.

This path, the pt’s relatives will not need an attorney, nor have money to hire an attorney, This involves a CRIME… the state’s bureaucracy would do the “heavy lifting”

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