Wednesday, May 26, 2021
I believe the menagerie of creatures that live around our house are celebrating reptile and amphibian week - frogs, turtles, and skinks are making daily appearances. The turtles have prolonged opportunities to admire the landscaping as they amble across our yard (they are demonstratively not teenage, mutant, nor ninja). And, it is hard to know what is on their mind. The enormous, older snapping turtle peering in my office window on Monday looked a bit judgy (and skeptically) at my treadmill desk. I can only imagine what they think of hairless apes that spend hours grooming the outdoors and walk in place going nowhere.
Meet the judgy, skeptical turtle:
https://share.icloud.com/photos/0eIoJZN1HD6n5bc0oW7pVEy_w#Severna_Park
-------
CDC National Hospitalization trend data
https://covid.cdc.gov/covid-data-tracker/#hospitalizations
Global-View:
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938
Nationally:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&areasRegional=ustx&areasRegional=usco&cumulative=0&logScale=0&perMillion=1&values=casesf
The U.S. Regionally - N.Y. Times:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Vaccine Tracker
https://covid.cdc.gov/covid-data-tracker/#vaccination-trends
-----
Moderna will soon get approval for use in 12 to 17-year-olds. Moderna observed no COVID infections in the 3700 teens vaccinated as part of Moderna's phase 2/3 trials, compared to 4 cases in the control groups. Side effects were as expected. Go science.
https://www.cnbc.com/2021/05/25/covid-vaccine-moderna-says-shot-is-100percent-effective-in-teens-plans-to-seek-fda-ok-in-june.html
Dr. Dhruv Khullar offers a great discussion in the New Yorker about how the end of the pandemic might play out - spotty, regional variation in disease incidence and prevalence based on a community's immunization rates.
https://www.newyorker.com/science/medical-dispatch/the-beginning-of-the-end-of-the-american-pandemic
Here is a pre-release study that found "A single dose of [the Pfizer] vaccine up to 15 months after SARS-CoV-2 infection provides neutralizing antibody titers exceeding two vaccine doses in previously uninfected individuals." In other words, even a single dose of the mRNA vaccine in previously infected individuals provided a significant boost to immunity with protection to, most likely, a more comprehensive array of variants. Mr. Senator Dr. Rand Paul would be wise to read this study.
https://www.medrxiv.org/content/10.1101/2021.05.25.21257797v1
Other variations in dosing strategy also seem to offer different levels of antibody response as well:
https://www.forbes.com/sites/siladityaray/2021/05/14/study-finds-12-week-gap-between-pfizer-covid-19-vaccine-dose-generates-35-times-higher-antibody-response/
Just remember - it is still not 100% clear what the clinical impact of any given antibody level is, but a robust antibody response is comforting.
A loyal reader and I were discussing the group of patients who are vaccine non-responders yesterday evening. While the clinical impact (can they get sick with COVID and what does that look like) is unclear, I find it concerning that immunosuppressed patients, including some percentage of dialysis patients, do not generate antibodies to the vaccine. These individuals should be wearing masks and avoiding indoor crowds until local COVID rates are minimal. However, we are getting a better sense of who these patients are. In this article, patients using rituximab and mycophenolate (two immunosuppressant medications) were non-responders.
https://www.acpjournals.org/doi/10.7326/M21-1451
A solid Twitter discussion with links to other articles:
https://twitter.com/EricTopol/status/1397015378337812481
Infographic of the day: Materials Science of Cycling
https://twitter.com/cenmag/status/1396881282139934725/photo/1
-----Bonus Round - Observational Science
Being a sharp observer is not relegated only to those with degrees. Learn about traditional mezcal production, the importance of bubbles, and the engineer who validated the process of knowing when mezcal is "ready." You can also learn about Marangoni flow - the phenomenon that creates intricate patterns of adult beverages sticking to the side of a glass. As such, the Marangoni effect provides a momentary distraction to stare at our drinks amid awkward conversations with people we only know through dinnertime stories but meet at our spouse's company holiday party (and other events too).
https://www.atlasobscura.com/articles/science-of-mezcal
and
https://www.nature.com/articles/s41598-020-67286-x
and
https://en.wikipedia.org/wiki/Marangoni_effect
Clean hands and sharp minds,
Adam
I believe the menagerie of creatures that live around our house are celebrating reptile and amphibian week - frogs, turtles, and skinks are making daily appearances. The turtles have prolonged opportunities to admire the landscaping as they amble across our yard (they are demonstratively not teenage, mutant, nor ninja). And, it is hard to know what is on their mind. The enormous, older snapping turtle peering in my office window on Monday looked a bit judgy (and skeptically) at my treadmill desk. I can only imagine what they think of hairless apes that spend hours grooming the outdoors and walk in place going nowhere.
Meet the judgy, skeptical turtle:
https://share.icloud.com/photos/0eIoJZN1HD6n5bc0oW7pVEy_w#Severna_Park
-------
CDC National Hospitalization trend data
https://covid.cdc.gov/covid-data-tracker/#hospitalizations
Global-View:
https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938
Nationally:
https://ig.ft.com/coronavirus-chart/?areas=usa&areas=gbr&areasRegional=usny&areasRegional=usca&areasRegional=usfl&areasRegional=ustx&areasRegional=usco&cumulative=0&logScale=0&perMillion=1&values=casesf
The U.S. Regionally - N.Y. Times:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Vaccine Tracker
https://covid.cdc.gov/covid-data-tracker/#vaccination-trends
-----
Moderna will soon get approval for use in 12 to 17-year-olds. Moderna observed no COVID infections in the 3700 teens vaccinated as part of Moderna's phase 2/3 trials, compared to 4 cases in the control groups. Side effects were as expected. Go science.
https://www.cnbc.com/2021/05/25/covid-vaccine-moderna-says-shot-is-100percent-effective-in-teens-plans-to-seek-fda-ok-in-june.html
Dr. Dhruv Khullar offers a great discussion in the New Yorker about how the end of the pandemic might play out - spotty, regional variation in disease incidence and prevalence based on a community's immunization rates.
https://www.newyorker.com/science/medical-dispatch/the-beginning-of-the-end-of-the-american-pandemic
Here is a pre-release study that found "A single dose of [the Pfizer] vaccine up to 15 months after SARS-CoV-2 infection provides neutralizing antibody titers exceeding two vaccine doses in previously uninfected individuals." In other words, even a single dose of the mRNA vaccine in previously infected individuals provided a significant boost to immunity with protection to, most likely, a more comprehensive array of variants. Mr. Senator Dr. Rand Paul would be wise to read this study.
https://www.medrxiv.org/content/10.1101/2021.05.25.21257797v1
Other variations in dosing strategy also seem to offer different levels of antibody response as well:
https://www.forbes.com/sites/siladityaray/2021/05/14/study-finds-12-week-gap-between-pfizer-covid-19-vaccine-dose-generates-35-times-higher-antibody-response/
Just remember - it is still not 100% clear what the clinical impact of any given antibody level is, but a robust antibody response is comforting.
A loyal reader and I were discussing the group of patients who are vaccine non-responders yesterday evening. While the clinical impact (can they get sick with COVID and what does that look like) is unclear, I find it concerning that immunosuppressed patients, including some percentage of dialysis patients, do not generate antibodies to the vaccine. These individuals should be wearing masks and avoiding indoor crowds until local COVID rates are minimal. However, we are getting a better sense of who these patients are. In this article, patients using rituximab and mycophenolate (two immunosuppressant medications) were non-responders.
https://www.acpjournals.org/doi/10.7326/M21-1451
A solid Twitter discussion with links to other articles:
https://twitter.com/EricTopol/status/1397015378337812481
Infographic of the day: Materials Science of Cycling
https://twitter.com/cenmag/status/1396881282139934725/photo/1
-----Bonus Round - Observational Science
Being a sharp observer is not relegated only to those with degrees. Learn about traditional mezcal production, the importance of bubbles, and the engineer who validated the process of knowing when mezcal is "ready." You can also learn about Marangoni flow - the phenomenon that creates intricate patterns of adult beverages sticking to the side of a glass. As such, the Marangoni effect provides a momentary distraction to stare at our drinks amid awkward conversations with people we only know through dinnertime stories but meet at our spouse's company holiday party (and other events too).
https://www.atlasobscura.com/articles/science-of-mezcal
and
https://www.nature.com/articles/s41598-020-67286-x
and
https://en.wikipedia.org/wiki/Marangoni_effect
Clean hands and sharp minds,
Adam
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