A version of this article appeared in this week’s It’s Not Just You newsletter. SUBSCRIBE HERE to have an It’s Not Just You essay delivered to your inbox every Sunday. March is the anteroom of months. It’s both the end of last year’s winter and the beginning of the new year’s spring. It’s half slush, half-quixotic hope. I had my first baby in March–a child that arrived nine days late, already a solid little being with startling almond eyes and the appetite of a toddler. I had no idea what I was doing; we two just hunkered down and tried to figure each other out.
But somehow, I slip-slide toward the end of the month, and things start to make sense. Maybe the vernal equinox is what helps get us back on track every spring. It’s that moment, usually, on the 20th or 21st of March, when the entire planet is in balance, both the northern and southern hemispheres have the same amount of daylight as darkness. This year we could use a little vernal harmony as we emerge like moles into the sunlight after 12 months of shutdowns and loss. Hope is still skittish these days, slipping in and out of the back door. But the numbers are going in the right direction. Vaccines are here in bulk, and while distribution still feels like it was set up by the folks who brought us the Hunger Games, that’s getting better too. My beloved Aunt Wissie even got her vaccination. She’s been on her own all this time. And she figured out where in Pennsylvania she could get an appointment, then drove hours West early in the morning to get her shot. Wissie always says, “you do the best you can with the tools you have.” And so she has done so for her 80 years. The other day, we talked about the miracle that is the COVID-19 vaccine and how, when she was young, polio terrorized many generations of parents and kids before the vaccine arrived in 1955, shutting down pools and camps every single summer. The experts say something approaching normal is coming our way this summer. It’s like we are waiting for a blockbuster movie. And if it were, the trailer would be just a litany of ordinary events, like a newborn being handed off to a string of aunties or people eating pizza in a booth with other humans after some sort of sports event. There’d be lingering shots of people in cafes writing about old-fashioned banal worries in journals. But for now, hope that little wraith won’t settle down. She remembers all the other times we saw numbers going the right way, and then something happened. So we will keep wearing face coverings for a little longer, maybe even trade up for a new spring mask look. And while we wait, let’s tally all the things we’ll want to take with us out of this tunnel. And yes, there’s so much much we never want to see again (or wear again), but there’s much to hang on to as well. For example, let’s not forget how to pay attention to what’s right in front of us. When the boundaries of your world got smaller with fewer distractions, we became much more aware of everything within that circle. This year has been a master class in observation. Like how we learned to really look at nature–whatever scrap of it was nearby. All the weird berries and bugs and plants and trees were always out there, undergoing dramatic changes every four months. Most of us city-folk just walked on by on hurrying to some restaurant or movie or work—all of which I’d obviously like to hurry to soon. But I don’t want to stop noticing the small pulses of spring as they grow stronger. Even people under 60 became obsessed with natural phenomena reporting back like breaking news if we found a new alien-looking seed pod in the park. And for a while, when commuter traffic disappeared, it was like someone turned up the bird volume, and that’s all you could hear, other than the haunting sound of ambulances in New York in April. And in that contained sphere of us, there were the people we quarantined with: The beloveds and the roommates and the kids. On the one hand, the days blurred into endless identical cycles. But in ten years, you’ll see that roommate, and no matter how rocky things got, there will be a bond between you like going to college together or boot camp.
That knowledge of how to be together for this long is precious. It’s as if we’ve all undergone a new version of that experiment the New York Times wrote about where they asked people who’d just met to stare into each other’s eyes for a certain amount of time and ask each other 36 questions. They fell in love or at least like. All this mashing together has been uncomfortable and sometimes painful, especially after the first few months. Yet, we found that familiarity can sometimes breed more love. And that goes for familiarity with ourselves too. Learning to be alone with yourself, bumping into your own faults at every turn, is one of those achievements that serve you well long after forced solitude ends. It’s the ultimate skill. And if you’re lucky, there’s a dog around. Now I know why poet Mary Oliver was always writing about her canines. They are the glue holding civilization together. At the very least, they force us to put pants on and leave the house regularly. That baby I had in March is now back at college, and so is their sibling. Until a few weeks ago, we three were rattling around in our 1100 square feet of Brooklyn, and lord, we fought at first. But I think about how I won’t forget watching the two of them, children of mine, learn to cook together–the sauces, the eggs, so many eggs cooked so many ways. I saw how they moved easily, like watch gears in the small kitchen sharing tasks without words. I had visions of them at my age, making those same dishes in some kitchen somewhere, chopping, handing plates off to each other easily because they also learned how to be grown-ups together during this endless year. So did I. But then again, I feel as if I have to remember how to be an adult again every March. ? If you’re new to It’s Not Just You, SUBSCRIBE HERE to get a weekly dose delivered to your inbox for free. Send comments and suggestions to me at [email protected]. If you’re new to It’s Not Just You, SUBSCRIBE HERE to get a weekly dose delivered to your inbox for free. COPING KIT ⛱<strong>And that is just the point… how the world, moist and beautiful, calls to each of us to make a new and serious response. That’s the big question, the one the world throws at you every morning. “Here you are, alive. Would you like to make a comment?</strong>Herewith, a bit of a challenge from poet Mary Oliver for a muddy and muddled Spring: We’re Having Trouble Recognizing Each Other In Masks, and It’s Getting Awkward Something for your pandemic scrapbook–amusing stories about the man who mistook his wife for a stranger and a bevy of new Biden administration officials who keep having to re-introduce themselves to each other. Expert Advice on Getting Through the Next Phase of the Pandemic from surprising sources, like Antarctic researchers. <strong>Fear, to a great extent, is born of a story we tell ourselves, and so I chose to tell myself a different story from the one women are told. I decided I was safe. I was strong. I was brave. Nothing could vanquish me. </strong></span> <span style="font-weight: 400;">To All the Clothes I’ve Loved Before, a meditation on one year of sweatpants, the fashion industry’s existential crisis, and what we miss about dressing up. EVIDENCE OF HUMAN KINDNESS ❤️Here’s your weekly reminder that creating a community of generosity elevates us all. Jacob, a 25-year-old psychology graduate student from Southern California, filled out a Pandemic of Love form indicating that he was willing to be an “anywhere” donor, giving across state lines and to any family in need of help. He was matched with Marshall, a 55-year old construction worker in North Carolina. Marshall requested help with his rent for the month of December. Marshall had fallen behind on his rent when he contracted COVID-19 and lost 5 weeks’ worth of wages: “Things were already tight, but I was grateful to be squeaking by every month at a time when so many people are suffering.” Marshall had a few conversations with Jacob and recalls being really impressed that someone “as young as Jacob could be so thoughtful.” After settling on what Jacob would be able to financially assist Marshall with, Jacob sent him an email with a list of what he would need to be able to help, and then…Marshall disappeared. Jacob attempted to contact Marshall several times, worried that perhaps something bad had happened or that perhaps Marshall’s health had taken a turn for the worst. After almost three weeks, Jacob received a call from a North Carolina number. “It wasn’t Marshall’s number, but I immediately answered because I thought maybe it was someone who read my text messages to him and saw how concerned I was about him.” On the other end of the receiver, there was silence and then, a clearing of a throat and finally the words, “Jacob, it’s Marshall, and I do believe I owe you an apology for the way I have treated you.” Jacob was so happy to hear Marshall’s voice but equally perplexed by his opening sentence. Marshall explained that after he had gotten Jacob’s email, he clicked on the University link in his email signature, intending to learn more about Jacob’s work and studies. He explained that he was shocked to see that Jacob was a Black man and that it was hard for him to wrap his head around being helped by “someone like you.” “Someone like me?” Jacob repeated back. Marshall explained that because of where he was from and how he grew up, his initial reaction was an embarrassment because he was asking for help in the first place and that getting help from a Black man “did not sit well” with [him] for some reason. “I sat with this for a long time, and I could not bring myself to tell you what my reaction was,” he said to Jacob. “I was embarrassed to ask for help but then even more embarrassed by my reaction. I work side-by-side every day with diverse people and I did not consider myself to be a racist, but meeting [Jacob] opened my eyes to the fact that I was not being completely honest about that. I knew this is not the person I want to be, but I was not sure how to come out and say it.” Marshall told Jacob that he’d understand if he did not want to help him any longer but that he wanted him to know how he felt and why he disappeared and that he was sorry. Jacob, recognizing what a momentous shift this was for Marshall and how brave and vulnerable he had to be to even have this conversation with him, thanked Marshall for his honesty and his thoughtfulness. “Of course, I agreed to still help Marshall,” said Jacob. Adding that it was an opportunity to “forge an even more meaningful connection with him.” This story is courtesy of Shelly Tygielski, founder of Pandemic of Love, a grassroots organization that matches those who want to become donors or volunteers directly with those who’ve asked for help with essential needs. ? Did someone forward you this newsletter? SUBSCRIBE to It’s Not Just You here. from https://ift.tt/3dTjNPp Check out https://takiaisfobia.blogspot.com/
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The U.S. Food and Drug Administration’s (FDA) vaccine advisory committee earlier today (Feb. 26) voted unanimously to recommend Johnson & Johnson’s COVID-19 vaccine for emergency use authorization. While the FDA isn’t obligated to follow the committee’s advice, it generally does. At the end of a full day of review and discussion of the company’s shot, all 22 voting members of the committee agreed that the vaccine was safe and effective enough to be used by the public. It’s the third vaccine that the group of independent experts has recommended, following Pfizer-BioNTech and Moderna. Unlike the two previous vaccines, J&J’s is a single shot, and can be shipped and stored under refrigerated, not frozen conditions, as the other two require. The single dosing played a part in the committee’s decision. Logistically, vaccinating people one time is much easier than asking them to return for a second dose. “This was a relatively easy call,” Dr. Eric Rubin, editor in chief of the New England Journal of Medicine and professor at Harvard T.H. Chan School of Public Health, who voted to recommend the shot said during the discussion. “[The vaccine] clearly gets way over the bar of safety and efficacy, and it’s a single-dose vaccine.” The committee members reviewed data presented by Janssen Pharmaceuticals, the J&J arm that developed the vaccine, as well as FDA scientists’ review of that data. Janssen’s vaccine uses a different technology than Pfizer-BioNTech and Moderna, which both relied on a new platform involving mRNA. Janssen’s vaccine, on the other hand, is made with a weakened cold virus that can’t cause disease, manipulated so that it carries the genes for making one of the key proteins of SARS-CoV-2, the virus that causes COVID-19. Once that viral protein is introduced to the body, human immune cells learn to recognize it as foreign and launch attacks against it. In Janssen’s primary vaccine study, involving nearly 44,000 people, a single dose was found to be 66% effective in protecting people from moderate to severe COVID-19 disease. It was slightly less effective in protecting against new variants of the virus—against one that was first identified in South Africa, it was around 57%. Still, that protection met the threshold of 50% efficacy set by the FDA for granting emergency use authorization. Committee members raised questions about how much of the immune response to the COVID-19 virus might be blunted by a response mounted against the weakened cold virus used as the delivery vessel, a well known effect using this vaccine platform. Such vaccines are also potentially less effective when boosted with additional shots since the body becomes tolerant to the weakened virus vector. However, Dr. Johan Van Hoof, managing director of Janssen Vaccines and Prevention, noted that tests on the company’s HIV vaccine candidate using similar technology have shown that people boosted with additional shots years after the first continued to generate strong immune responses that didn’t seem to be significantly affected by the weakened virus vector. Many committee members raised questions about the company’s data showing that the vaccine produced a slightly lower response in terms of antibody levels against the virus among people over age 60, especially those with underlying health conditions—a group particularly vulnerable to COVID-19. However, Janssen studies found that these people still did not develop severe COVID-19 disease or need hospitalization compared to people getting placebo. In fact, the vaccine was 85% effective in protecting people from severe disease and overall there were only 21 deaths among the 44,000 people studied; five occurring among those who were vaccinated and the remainder among the placebo group. None of the deaths were considered related to the vaccine. The FDA scientists did note in their review that some participants in the study did experience serious side effects, including tinnitus (ringing in the ears), clotting and hives—which could be related to the vaccine and are worth further follow up. However, these were rare, and overall the vaccine was safe with most who reported side effects having only mild to moderate reactions including headache, chills and muscle aches. The other question that continued to pop up during the day-long discussion focused on whether Janssen’s vaccine is really a one-shot vaccine or whether it, like the Pfizer-BioNTech and Moderna vaccines, actually requires a two-shot regimen. While the data the company submitted were from a trial in which participants were given only a single dose, the company is currently conducting another study of 30,000 people who will receive two doses of the shot—to see if an additional booster will raise immune responses even further. If two doses prove to be more effective, it will raise a tricky question about what to do with people who might receive the single dose shot in coming weeks or months, should the one-dose regimen be authorized. Van Hoof argues that this is a question worth putting off for later, given the urgency of the current situation. “We feel the results of the study of our single dose showed high efficacy against severe disease, especially hospitalizations and death, and in a situation of mass vaccination programs, our regimen is extremely well positioned to be used during the outbreak,” he said. Then of course there is the question of the recently identified genetic variants of SARS-CoV-2 that appear even more infectious than the original virus. Pfizer-BioNTech and Moderna did not have to deal with that when they submitted their requests back in December 2020, but the companies have since conducted additional tests that have shown that their vaccines remain effective in protecting against the major new mutations. Janssen’s submission to the FDA included some early data on the efficacy of its vaccine against the new variants, and Van Hoof told the committee that the company plans to continue genetic sequencing virus from people in the company’s trials if they test positive and will include that information in the final request for full approval which could come later this year. In the meanwhile, Janssen—like Pfizer-BioNtech and Moderna—is already working on a next-generation vaccine specifically targeting the new variants that could begin human testing by summer. The FDA committee’s decision to recommend the Janssen shot now goes to the agency. If the FDA agrees to grant the emergency use authorization, the next step will be for the Centers for Disease Control and Prevention’s immunization committee to work out details of who should be vaccinated with the new shot, and the logistics for how to make that happen. That CDC committee will also likely make decisions about whether certain groups should be targeted to receive this specific vaccine, and what advice to provide vaccinators when people ask about whether they will need a second shot. That information won’t be available until Janssen completes its two-dose study in coming months. from https://ift.tt/3pZf3dk Check out https://takiaisfobia.blogspot.com/ McMurdo Station, an Antarctic research base 2,415 miles south of Christchurch, New Zealand, is a strange place to ride out the COVID-19 pandemic. But it’s been a home of sorts for Pedro Salom since he took a dishwashing job there in 2001, when he was 24. Now an assistant area manager with more than a dozen Antarctic deployments behind him, Salom has grown accustomed to the ebb and flow of life on the ice. There’s the surge of excitement when new arrivals join the camp, the feeling of isolation from the rest of the world when earth and sea disappear in the endless night from April to August; and the joy when the sun finally appears behind the mountains once again. He’s also been around long enough to know that, as people reach the end of their deployments, many begin to struggle—whether they’ve been at McMurdo for over a year, or even just a few months. “One of the things I look for is dramatic changes in people’s habits,” says Salom. “If somebody has been going to the gym every day at 6:30 a.m., and usually gets to lunch exactly at 11:45, and that person suddenly misses the gym, or starts taking food to go or doesn’t show up for lunch at all, that’s a serious flag in my mind.” Researchers have a term for what Salom is describing: the “third quarter phenomenon.” First named in 1991 by researchers studying people living in cold regions, the phenomenon (still theoretical) is characterized by mood shifts among people nearly finished with a long period of isolation. Those affected often feel anxious, withdrawn, and increasingly vulnerable. Researchers haven’t been able to definitively prove the phenomenon exists, in part because its effects can vary from person to person. But anecdotal evidence and research suggest it often strikes people beginning 75% of the way through an isolating event. While researchers looking into the phenomenon have focused on explorers like Salom, what they’ve learned about it could now be applicable to a much larger group of people: those self-isolating during the COVID-19 pandemic, which, at least in some parts of the world, is potentially about three-quarters through—assuming vaccine rollouts proceed apace, and the shots perform as expected. Nathan Smith, a University of Manchester researcher who has examined how people behave in extreme settings, says that “the psychological and social experience of monotony, sensory deprivation, social isolation, proximity with others, is very similar” to that likely being experienced by people isolating during COVID-19. “For some people, this third quarter phase may be really challenging,” he says. The third quarter phenomenon can lead some to experience major mood shifts and change the way they relate to other people. For instance, last March, Sunniva Sorby, 59, and Hilde Fålun Strøm, 53, said they had a hard time during what they thought was the end of their stay in an uninsulated 90-year-old trapper’s cabin without electricity or running water on Svalbard, a Norwegian archipelago in the Arctic Circle. The pair of climate change researchers had spent more than seven months, much of it in the Arctic darkness, collecting invaluable data by observing wildlife, using a drone to measure surface ice and land temperatures, and taking ice core and phytoplankton samples. But as the end of their stay drew near, Sorby and Strøm’s excitement about seeing their loved ones again was tempered by a wave of unexpected anxiety. They worried about many things: whether they would finish the research they started together, how the end of their mission might affect their friendship, and whether they would ever actually finish packing up to leave. “In the dark, we’re totally dependent on each other. And then when the light starts to come back, there’s a question around how much tending is needed from the other,” Sorby says. “It can breed insecurity.” Polar explorers aren’t the only people who spend long stretches of time in relative isolation. Take submariners like Matt Kilby, a 29-year-old former U.S. Navy lieutenant who served three deployments aboard the U.S.S. Florida. Although he says the ship was roomier than you might expect, many indoor spaces can still feel tight, especially for someone like him, who stands 6’4” tall. Life aboard the ship—which on one 110-day deployment spent 107 days submerged—sometimes felt like Groundhog Day, the Bill Murray classic about a TV weatherman stuck in a time loop, Kilby says. While he had his crewmates for company, Kilby could only communicate with his friends and family, including his fiancée, by email, which at times made him fear being forgotten. By the last week of any given long-term submarine mission, Kilby says, the crew tended to get testy. “It’s almost so well known, that if someone blows up on you, it’s just like, ‘Hey, man, it’s like the last week, everyone’s like this right now.’ So everyone’s almost bonding over the fact that it’s that last week and that everybody’s grumpy.” Participants in projects that simulate long-term space travel to better understand its potential psychological effects also say they’ve observed the phenomenon. Shannon Rupert, a 61-year-old former professor of biology and environmental science now runs the Mars Desert Research Station in Hanksville, Utah, which is operated by the space advocacy nonprofit the Mars Society—where hundreds of people have “settled” on the Red Planet. To emulate life at a space station, the quarters are tight—Rupert compares the bedrooms to closets—which means you can never really get away from the five or more other participants, or out of earshot of their conversations. Even when participants venture outside, they’re required to wear bulky model spacesuits; participants can go through the entire experience without feeling the wind on their face. Rupert says she often warns participants that the project becomes more difficult three-quarters of the way through. Rupert, who herself has taken part in more than a dozen simulated Mars missions varying in length from several weeks to a few months, advises participants to share their pet peeves early on to avoid fights down the road (she hates when people brush their teeth in the kitchen sink, for instance). During one simulation, two crewmates came to blows after one was caught squirreling away the group’s hot chocolate mix, she says. “The little irritations that didn’t bother you… become suddenly not okay,” says Rupert. “The last couple of days, you’re gonna like be like,’ dude, get the hell out of here.’” In extreme cases, some participants have walked away from the simulation early. Rupert adds that mental fatigue often leads to accidents and injuries during this leg, and she worries that, in the context of COVID-19, the same phenomenon could lead people to give up social distancing and other preventative measures as they tire of following public health guidelines. In other words, the fact that we may nearly be out of the pandemic woods—thanks largely to mass vaccination efforts underway—may present new psychological hurdles. If you’re feeling particularly irritable, unhappy or otherwise off lately, it may help to understand these potential psychological forces at work. “If you know [isolation] is going to end, it sort of makes sense to conserve some of your resources and save them for when you might be going back into a slightly more dynamic and changeable environment,” says Smith, the University of Manchester researcher. But it’s essential that we all stay vigilant, because we’re a long way from herd immunity, and until we reach that point, the virus could easily reassert itself. Indeed, social distancing may become psychologically harder before it gets easier, since vaccinated people are likely to begin to enjoy a more normal life before those of us who remain unvaccinated. The adventurous souls who spoke to TIME about their experience with third quarter syndrome relied on remarkably similar coping mechanisms, all centered around the notion of focusing on their mission. For Sorby and Strøm, that’s been promoting positive action to combat climate change; for Kilby, it was to serve his country; for Rupert, it’s about better preparing humanity to become a species of interstellar explorers; and for Salom, helping to keep McMurdo Station safe. For those of us isolating because of COVID-19, the goal is simpler but no less noble: reducing the spread of the virus and keeping as many people from getting ill as possible. But even seasoned pros can find their willpower drifting sometimes. When that happens, the people who spoke with TIME recommend concentrating on the here and now—keeping to a routine that offers a sense of control, or appreciating whatever little joys you can find along the way. Salom says his life has been enriched by getting outside to hike, stargaze or watch the aurora australis (the southern sibling of the northern lights). Routinely exercising has been important, he says, as has his pursuit of fun projects: hosting trivia nights; opening “pop up restaurants” and organizing pinewood derbies. Salom’s time in the Antarctic has also given him a greater appreciation of the importance of mental health. It can be tough to speak up and ask for help, Salom says, but it’s essential to realize that psychological health is very much like physical health: “early intervention and engagement is much better than then trying to make up for lost time later on, when somebody gets in a really bad place.” from https://ift.tt/2MtohAV Check out https://takiaisfobia.blogspot.com/ When Pfizer-BioNTech’s vaccine became the first authorized for use in the U.S., the good news came with a catch: the vaccine, the first of its kind using a new mRNA-based technology, needs to be stored at ultra-cold temperatures (-80°C to -60°C) until thawing just before being injected into people’s arms. State health centers, hospitals and other potential vaccination sites scrambled to acquire special freezers that could reach these deep-freeze temperatures, and Pfizer developed a special shipping container that could keep doses appropriately chilled for up to a month as long as the container was continuously supplied with dry ice. Still, the temperature requirement meant some locations opted not to order the Pfizer-BioNTech vaccine. But in the past few weeks, the U.S. Food and Drug Administration reviewed data submitted by the companies on the stability of the doses at normal freezer temperatures (-25°C to -15°C), and on Feb. 25, the agency issued new guidance that says the vaccine can be safely shipped and stored for up to two weeks at these relatively higher temperatures. While that’s a shorter time period than the six months that the vaccine can be stored in freezers reaching ultra-cold temperatures, the option could give more hospitals, doctors’ offices, pharmacies, and health clinics the flexibility they need to effectively store and administer doses of the vaccine. “It gives people more storage options, and more accessibility in locations that today may not be ordering the Pfizer vaccine,” says Tanya Alcorn, vice president of Pfizer’s BioPharma Global Supply Chain. The data that led to the FDA’s decision was generated as part of the companies’ routine quality-control studies, which include analyses of how stable the vaccine is even if it wasn’t kept at the recommended -80°C to -60°C. Much of that work occurred in Pfizer’s Andover, Mass. facility, which also produces the mRNA that goes into the vaccine. “We take multiple lots and do a full battery of testing, including putting them in temperature-controlled stability chambers,” says Margaret Ruesch, Pfizer’s vice president of worldwide research and development, and site leader for the Andover location. “We collect those stability data and if we have enough that gives us assurance that all the vaccines meet with our specifications under those storage conditions, then we request an update of the recommendation for how the vaccine is stored.” The companies initially launched the vaccine with the -80°C to -60°C temperature requirement because that was the temperature range at which they produced the doses used in their clinical trials. “We had plenty of data on stability at the ultra-cold temperatures,” says Ruesch. “As we made more commercial-scale lots, we took those lots and put them in our stability program and gathered enough data on the [regular] freezer temperatures” to confirm that they could be safely stored at those temperatures for up to two weeks. Pfizer-BioNTech will continue shipping doses in its ultra-cold temperature containers, but once received, facilities will now be able to keep the vials in those shipping containers for a month and then place them in a regular freezer for up to two weeks. “The alternative temperature for transportation and storage will help ease the burden of procuring ultra-low cold storage equipment for vaccination sites and should help to get vaccine to more sites,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research said in a statement announcing the decision. Pfizer-BioNTech has been scrambling to meet aggressive production targets after a slower-than-expected rollout has left states and jurisdictions short on doses. Part of that slower manufacturing was due to initial challenges in getting sufficient raw materials needed for the vaccine, and a less-than-optimal production process. But as manufacturing has ramped up, Alcorn says, production is on pace to more than double from January to mid-March, from five million doses a week to about 13 million. The companies have contracted to deliver 200 million doses to locations in the U.S. by May, and hope to ship 2 billion doses globally by the end of the year. “We are very, very confident in our ability to meet targets,” says Alcorn. from https://ift.tt/2ZUK7jG Check out https://takiaisfobia.blogspot.com/ My Family Is Still Being Careful About COVID-19. Why Does It Feel Like Were the Only Ones?2/25/2021 Welcome to COVID Questions, TIME’s advice column. We’re trying to make living through the pandemic a little easier, with expert-backed answers to your toughest coronavirus-related dilemmas. While we can’t and don’t offer medical advice—those questions should go to your doctor—we hope this column will help you sort through this stressful and confusing time. Got a question? Write to us at [email protected]. Today, K.K. in California asks:
It makes total sense that you would be concerned for your son. For the most part, children his age have been spared from the worst of COVID-19, but the virus can be devastating for people with underlying conditions—and being born prematurely may count as one, even though your son is now almost two. As you probably know, people born prematurely sometimes have health problems for life; many also have under-developed respiratory systems, which is especially relevant during the COVID-19 pandemic. There’s not much research on prematurity and COVID-19 specifically, but one February 2021 study from researchers at Children’s Hospital Colorado found that kids who were born preterm were at increased risk of being hospitalized after testing positive for COVID-19. Dr. Samuel Dominguez, one of the study’s authors, says that risk is most serious for preterm babies, and gets progressively lower as a child grows up (assuming their health is fairly stable). Nonetheless, “we do know for other respiratory viruses that premature kids are at risk for more severe disease,” Dominguez says. “Premature kids often have problems with their lungs, so we worry about respiratory infections in that population in particular.” The bottom line, Dominguez says, is that your family—just like all families—should be following public-health guidelines, including wearing masks, social distancing and keeping social interactions outdoors to the extent possible, at least until you’re vaccinated. As for whether your son is suffering due to reduced social interactions, Dr. Sandra Friedman, director of developmental pediatrics at Children’s Hospital Colorado, says the most important thing is to keep up with regular doctor’s visits, even during the pandemic. Your son’s physician should perform age-appropriate developmental screenings that can alert you to any potential issues. If those screens appear normal, “if you play with your son, read to him, narrate activities while they are occurring and provide him with an enriched environment, he should continue to do well,” Friedman says. But that only addresses half of your letter. You’re also asking another question: “Why does it feel like everyone else has forgotten about the pandemic?” I wish I knew the answer, because I’ve had this conversation with friends many times! At the very least, know that you aren’t alone in feeling alternately over-cautious and confident you’re doing the right thing. You’re also far from the only person still taking precautions. Some data actually show that more people in the U.S. are wearing masks and social distancing now compared to a few months ago, believe it or not. But statistics aren’t super helpful when you’re faced with daily, in-person reminders that your loved ones are going back to pre-pandemic life while you’re still in quarantine mode. It may help to cut down on those reminders, says Dr. Jessi Gold, an assistant psychiatry professor at the Washington University in St. Louis School of Medicine. If you have certain friends or family members whose behavior makes you feel particularly anxious, or with whom you constantly butt heads about what’s safe to do right now, you may want to temporarily ease back from those relationships, or at least swear off talking about the pandemic together. Simply muting people’s vacation posts on social media can go a long way, too. It may also help to reach out to loved ones, or even friendly acquaintances, who seem to view the pandemic similarly to the way you do. “It’s never good to be in a complete echo chamber,” Gold says, “but in circumstances where you feel really alone…it can be helpful to seek out someone who understands.” Remind yourself of why you’re taking precautions, too. “You can sometimes evaluate a thought with evidence,” Gold suggests. When you start to feel like the only one who cares about the virus, remember that you’re basing your choices off the advice of the nation’s top health officials, not some arbitrary decision on your part. “If you take a step back and realize that you’re living in line with your values, that’s important, too,” Gold adds. Thinking of your son, and your desire to keep him safe, may give you strength. And make sure you’re taking care of yourself, Gold says. The pandemic is hard and stressful, and no amount of self-care will change that. But taking even a few minutes a day to read, take a bath, exercise, watch your favorite reality show or whatever helps you recharge may help you stay motivated enough to do it all again tomorrow. And take comfort in the fact that more people are getting vaccinated every day, which means better times are ahead. from https://ift.tt/2ZSA1jv Check out https://takiaisfobia.blogspot.com/ 2021 got off to a grim pandemic start in the U.S. A huge surge in COVID-19 cases followed the holiday season, peaking at around 300,000 new cases on Jan. 8, 2020. More than 20,000 Americans lost their lives to the virus in a single week in January alone and over 146,00 in total have died since the start of the year. But six weeks later, the picture looks more promising. New daily cases have fallen sharply, daily deaths have fallen to levels not seen since Thanksgiving, and the pace of vaccine roll-out is speeding up. These positive trends mean that we can now begin to ask what the endgame might look like. Would we be happy with an endemic scenario in which disease levels are kept low but SARS-CoV-2 continues to circulate indefinitely, perhaps with the same kinds of seasonal peaks as we see with flu? Or should we aim higher and attempt to eliminate the disease, meaning there would be no new cases of that disease within our borders? A third scenario is eradication—achieving zero new cases worldwide—but this would be an enormous and highly uncertain global undertaking (we’ve only eradicated one human infectious disease, smallpox). For elimination in the U.S., we’d need to be able to detect all imported cases at the border and place those people in managed isolation until they are no longer infectious. We’d also need a high-performing surveillance system that can test enough Americans every day to be able to quickly detect and extinguish any outbreaks. To be sure, we have a long and hard road ahead of us to reach either low endemic levels (the flu scenario) or elimination. There are still huge amounts of infection and transmission in the U.S. There are growing concerns that the more transmissible B.1.1.7 variant, which is doubling every 10 days in the U.S., could cause cases to rise again, and we do not yet have a high-performing nationwide test-and-trace surveillance system in place—let alone adequate support for those infected to isolate themselves or for their contacts to quarantine. Nor have we adopted measures at our borders to reliably detect imported cases and isolate them. But none of this should be cause for fatalism. With a multi-faceted approach we can continue to drive down transmission and daily case numbers. Proven public health measures, such as masking (ideally with high-filtration masks), distancing, and avoidance of poorly ventilated buildings, should be maintained to protect the unvaccinated and break the cycles of transmission. The roll-out of rapid antigen tests, which would be funded in President Biden’s $1.9 trillion stimulus proposal, would help people return to work and school. Stepping up our genomic surveillance will help guide decision makers as known and new variants start spreading. In parallel, more Americans will get vaccinated, dramatically reducing their chances of severe illness or death. Based on promising early data from Israel, it also looks like some vaccines may reduce transmission. In other words, while a vaccinated person can still test positive for SARS-CoV-2, the vaccine reduces the chances that they’ll spread the virus to others. If this is the case, every person who is vaccinated will contribute to a firebreak that will stop future surges of infection before they happen. To get there, experts believe we need about 70% of the population to have immunity due to either vaccination or past infection, and probably closer to 80% (or even higher) in the case of more transmissible variants. We will need to continue to monitor the situation closely and be ready to take prompt action where things are not working. For a start, vaccines are still not readily available, particularly to Black Americans, who are being offered shots at much lower rates than white Americans. Even when availability becomes widespread, perhaps by August, a significant proportion of Americans say they do not wish to be vaccinated, for reasons that we need to better understand. We need to listen to their concerns, not dismiss them, because the more people are vaccinated, the better the community as a whole is protected. This approach will gradually transform our lives such that the restrictions can start to be lifted once we’re out of the woods. But there won’t be a “light switch” moment when suddenly the disease has been halted. A spring or winter surge could yet occur, requiring the return of restrictions. The only way to be sure that won’t happen is elimination. Elimination is a tall order. But large parts of the world have managed it for other viruses, like polio and measles—although the potential for reintroductions means we must stay alert and keep vaccination levels high, as shown by a recent measles outbreak in California in which fully 76% of those infected had chosen to go unvaccinated. An easier goal to reach would be low-level endemicity, in which SARS-CoV-2 circulates but is less deadly thanks to regularly updated vaccines, vaccine boosters, and new treatments (all of which “de-risk” the virus). In a poll of over 100 infectious-disease researchers, virologists, and immunologists working on the coronavirus, 89% felt that SARS-CoV-2 was likely or very likely to become an endemic virus. As outcomes, elimination and endemic transmission may be opposites, but thinking that we need to choose one or the other is a mistake that can impede public understanding of how to manage the pandemic. All the tools that have been used to achieve local elimination of SARS-CoV-2 in places like Australia, Taiwan, and New Zealand—such as test and tracing, case isolation, quarantining of exposed people, border management, and aggressive outbreak control—prevent transmission. These tools avoid the agonizing choice between prolonged damaging lockdowns or prolonged and massive strain on healthcare. And we now have effective vaccines to help the elimination effort. But vaccines alone do not guarantee elimination, much less worldwide eradication. Nevertheless, recent results from the United Kingdom and Israel suggest that vaccination has rapid benefits, including marked reductions in the numbers needing hospitalization. The benefits of acting like elimination is possible, even if the harsh reality proves otherwise, are illustrated by those countries that took that approach. Countries like Australia or New Zealand will be embarking on their vaccination campaigns having suffered a tiny fraction of what the U.S. has endured. In a growing number of U.S. states, more than one in every five hundred people have died from COVID-19. The equivalent figure for New Zealand is one in a million. Which do you think is the better place from which to be rolling out an effective vaccine? There is one thing we can say with certainty: whichever endgame the U.S. chooses will involve trade-offs and we should be open about these. For example, countries that are attempting elimination have returned to a near normal life but they must curtail travel (only to and from other eliminating nations) and maintain strict border measures. If the virus is introduced into unvaccinated communities, as seen recently in Auckland, New Zealand, strong interventions may be necessary. On the other hand, accepting endemicity means we will have to “tolerate” some level of deaths, probably with seasonal peaks. This is how we currently handle seasonal influenza; we work to minimize infections and their consequences when we cannot eliminate them, and society accepts the resulting risks. Risks cannot be reduced to zero or none of us would ever get in a car. It is time for an open discussion of the U.S. endgame. While experts can provide scientific advice, given the difficult policy choices ahead, a more inclusive and participatory dialogue is needed, through hearings, town halls and citizen panels. Such deliberative democracy may start to bind up the wounds—pandemic and otherwise—of the intensely partisan 2020. Meanwhile, we need to get vaccines into arms and ensure the virus and its variants never again experience such ready access to so much unprotected human real estate. from https://ift.tt/3pUsPxU Check out https://takiaisfobia.blogspot.com/ Pfizer-BioNTech has begun testing a third dose of its COVID-19 vaccine in a small group of people. The vaccine is currently authorized in several countries in a two-dose regimen, given 21 days apart, and has proven in studies to be about 95% effective in protecting against COVID-19 disease. But as new (and more infectious) genetic variants of the COVID-19 virus start circulating—so far, scientists have identified three major strains, first found in the U.K., South Africa, and Brazil, respectively—questions about how well authorized vaccines can still thwart the virus have become more urgent. Pfizer-BioNTech have already done studies testing blood serum from people vaccinated with their original shot against some of these variants, and found that the immune response triggered by the two doses is still quite protective. In fact, in the case of the U.K. variant (referred to as B.1.1.7), levels of antibodies produced by the vaccine regimen, an important immune defense against the virus, were similar to levels against the original, non-mutated virus. However, the researchers found that the level of antibodies produced by the original vaccine were lower against the South African variant (referred to as B.1.351). Pfizer-BioNTech hasn’t yet completed the same level of rigorous testing against the Brazilian variant (referred to as P1). “So far we haven’t heard any reports of breakthrough cases [among vaccinated people] related to any of the new variants,” says Mikael Dolsten, chief scientific officer at Pfizer, referring to serious infections with the variant viruses among vaccinated people. “But we always want to be one step ahead of the virus. That made us think about generating data on a third boost. We are going to give people who were part of our Phase 1-2 study from last summer a boost with another dose of the current vaccine. We expect that the antibody levels may rise against current variants to strengthen protection.” Only a clinical trial will prove that. Pfizer-BioNTech plans to vaccinate 144 people who were enrolled in the companies’ early phase studies, who received their second dose between six and 12 months ago. In the event that the additional dose does not enhance people’s protection, Dolsten says Pfizer has also developed a new vaccine targeting the South African variant, which has shown the most resistance to vaccine-induced immunity so far. Because the mRNA technology on which the original vaccine was built only requires the right genetic sequence to build a new version, Dolsten says developing a new vaccine targeting the South African variant only took six to eight weeks. In about a month or so, he says, Pfizer plans to begin a trial in which researchers will give participants who got two doses of the original vaccine a third dose—of the new variant vaccine. It’s all part of a dry run for what might become a routine process in coming years: shifting to new versions of the vaccine after a few months, or a year or so, similar to the way seasonal flu vaccines change depending on which strains are circulating each influenza season. Producing the new COVFID-19 vaccine and testing it, Dolsten says, “paves the way for more rapid changes in the future. If the virus mutates beyond what we see today, we will already have data on how to do a strain shift and rapidly change production. We could just feed the production process with a different mRNA and everything else would be the same.” He stresses that the original vaccine that received U.S. Food and Drug Administration emergency use authorization continues to protect well against all variants of the virus, but that all of these measures are ways to “constantly have options to stay ahead of the virus and move very fast if we see less protection against any new [mutant] strains.” from https://ift.tt/3uxRRGn Check out https://takiaisfobia.blogspot.com/ It’s one thing to test a vaccine, and another to see it in action in the real world. More than two months after the first vaccines were authorized in the U.K. and U.S., strong data have emerged showing that the shots are doing what they are supposed to do: protect people from COVID-19. In a study published Feb. 24 in the New England Journal of Medicine, researchers in Israel and the U.S. report that the vaccine made by Pfizer-BioNTech was highly effective in protecting against infection with the COVID-19 virus, lowering people’s chances of getting sick with the disease—especially severe disease—and dropping COVID-19 hospitalization rates. The data, says Marc Lipsitch, professor of epidemiology at the Harvard T. H. Chan School of Public Health and co-author of the paper, are “close to the best possible news.” In a separate pre-print study published in the Lancet on Feb. 19 that hasn’t yet been peer reviewed, health officials in Scotland also reported that vaccination with either the Pfizer-BioNTech or AstraZeneca shot was helping to lower hospitalization rates due to COVID-19 in the country. Those results were especially encouraging, they said, because they showed that even a single dose of either vaccine was 85% to 94% effective in reducing COVID-19 hospitalization within a little more than a month after the first shot (the recommended dose is two shots of either vaccine). The findings are a real-world harbinger of what the world can expect as more people get vaccinated and throw up a wall of immunity against the virus. Israel may lead the way in providing hints of where the pandemic is headed. With a unique nationally coordinated system for vaccinating people, and a tight connection between who gets the shots and their health records, the country is a scientist’s ideal study group. In the NEJM study, researchers included data from nearly 600,000 vaccinated people, and compared them to a similarly sized group of people who hadn’t gotten the vaccine. After two doses, the vaccine, it turned out, was 92% effective in preventing infection and, among those who did get infected, 92% effective in protecting against COVID-19 symptoms, 92% effective in protecting against severe disease, and 87% effective in protecting people from needing hospitalization for COVID-19. The results mirror those found by Pfizer and BioNTech in their late-stage study of 44,000 people, which also showed the vaccine could dramatically reduce the risk of COVID-19 illness, especially severe disease. But having real world data further bolsters that effectiveness data, and could go a long way toward addressing some of the reluctance people feel about getting the shot because it was developed and tested so quickly. As encouraging as the results are, Lipsitch says they still don’t answer an important question about the protection that vaccines provide: how long that protection, or immunity, lasts. “We still don’t know how good that vaccine is three month out, or six months out,” he says. That’s where the unique situation in Israel may also shed some light in coming months. If similar studies continue, researchers can monitor any changes in vaccinate people’s antibody levels and get an idea of whether protection against the COVID-virus is waning, or remains strong. “There is lots of reason to believe that it’s going to be good based on what we know about immunology and the durability of immune responses to vaccines,” he says. But more data will be needed to confirm that. from https://ift.tt/3dFBJwJ Check out https://takiaisfobia.blogspot.com/ On Feb. 24, Massachusetts-based biotech Moderna announced that has shipped a new version of its already-authorized COVID-19 vaccine to testing sites. The new vaccine is one aspect of a three-part strategy the company is taking to address new viral mutations that make the virus more infectious. They plan to test them in both participants of the early trials of the original vaccine, who were vaccinated six to 12 months ago, as well as unvaccinated individuals. All three efforts involve studying adding a third dose following the current two-dose regimen of Moderna’s vaccine, which has emergency use authorization from the U.S. Food and Drug Administration (FDA). One study will simply add a third dose of the existing vaccine to the two-dose regimen. The company’s earlier data showed that while its original vaccine continued to provide sufficient protection against COVID-19 disease caused by the major known faster-spreading mutations, that protection was diminished somewhat against one of the variants that was first identified in South Africa, known as B.1.351. This study will investigate whether adding a third dose of already authorized vaccine can increase virus-fighting antibodies to levels that would provide the same protection as the two-dose regiment provided against the original, non-mutated virus. The company is also testing a new vaccine that it developed specifically against the B.1.351 variant. Moderna’s vaccine relies on mRNA technology, which enables the company to rapidly develop new versions simply by changing the genetic information programmed into the shot. (The original vaccine was developed in a record 42 days, and began human testing in a record 63 days; the new vaccine was similarly developed in about six to eight weeks). In the initial trials, Moderna is testing this new vaccine as the third dose after two doses of the original vaccine are given. Finally, the vaccine maker’s scientists are also testing another new vaccine that combines the original and the new version designed to protect against the B.1.351 variant. This vaccine too would be used as a third dose after two doses of the original shot. Additionally, the company said in a statement that it also plans to study the two new vaccines as stand-alone shots in people who have not yet been vaccinated and are negative for COVID-19, to see if the shots can protect against disease on their own. The company said these studies are being done “out of an abundance of caution,” noting that its original vaccine still provides strong protection against COVID-19 disease. But infectious disease experts are growing concerned about the new variants that are popping up—especially B.1.351, which seems to be more resistant to the current immune defenses the body makes after being vaccinated. In a Moderna study first released in January and later published in the New England Journal in February, the company reported a six-fold drop in the level of antibodies that can neutralize the B.1.351 virus, as compared to the non-mutated version of virus. The company hopes that amplifying the immune response generated by the original vaccine with a third dose, either of the same shot or one of the new ones, will make up for that diminished immune attack. Depending on the results of the studies, Moderna will work with regulatory authorities like the FDA to decide whether any changes to the current authorization will be needed, and if the company can provide the vaccine to the public. Alongside the Feb. 24 announcement of these new studies, company officials also committed to producing an extra 100 million doses of its original vaccine this year, for a total of 700 million doses globally in 2021. To further expand the number of doses reaching people who need them, Moderna said it is also investigating ways to include up to 15 doses in each vial, instead of the current 10. from https://ift.tt/3uxeg6I Check out https://takiaisfobia.blogspot.com/ (ACCRA, Ghana) — Ghana received the world’s first delivery of coronavirus vaccines from the United Nations-backed COVAX initiative on Wednesday—the long-awaited start for a program that has thus far fallen short of hopes that it would ensure shots were given quickly to the world’s most vulnerable people. The arrival of 600,000 doses of the AstraZeneca vaccine in the West African country marks the beginning of the largest vaccine procurement and supply operation in history, according to the World Health Organization and UNICEF. It is a linchpin of efforts to bring the pandemic to an end and has been hailed as the first time the world has delivered a highly sought-after vaccine to poor countries during an ongoing outbreak. “Today marks the historic moment for which we have been planning and working so hard. With the first shipment of doses, we can make good on the promise of the COVAX facility to ensure people from less wealthy countries are not left behind in the race for life-saving vaccines,” said Henrietta Fore, executive director of UNICEF, which delivered the vaccines. But the initiative, formed to ensure fair access to vaccines by low- and middle-income countries, has been hampered by the severely limited global supply of doses and logistical problems. Although it aims to deliver 2 billion shots this year, it currently has legally binding agreements only for several hundred million shots. It already missed its own goal of beginning vaccinations in poor countries at the same time immunizations were rolled out in rich ones, some of which have now administered millions of shots. That delay led numerous poorer countries to rush to sign their own deals, potentially undermining COVAX’s efforts to get shots to the neediest people worldwide. And some countries can’t afford to go it alone. Ghana is among 92 countries that will receive vaccines for free through the initiative, which is led by the WHO; Gavi, a vaccine group; and the Coalition for Epidemic Preparedness Innovations. Another 90 countries and eight territories have agreed to pay. Ghana, a nation of 30 million people that has recorded 81,245 cases and 584 deaths since the beginning of the pandemic, plans to begin vaccinations on March 2. Neighboring Ivory Coast will be the next to receive vaccines, and also will roll them out starting next week. Even as it celebrated receiving the first doses, Ghana noted the long road ahead. “The government of Ghana remains resolute at ensuring the welfare of all Ghanaians and is making frantic efforts to acquire adequate vaccines to cover the entire population through bilateral and multilateral agencies,” Ghana’s acting minister of information, Kojo Oppong Nkrumah, said in a statement. That freneticism has been echoed across the continent of 1.3 billion people, as deliveries have fallen behind schedule and African nations have scrambled to secure vaccines from various sources. Only about seven of 54 have begun vaccination campaigns. Some activists have also expressed serious concern about the COVAX initiative’s goal of only giving enough shots to cover about 20% to 30% of the population in countries that receive donated doses. They have warned that even if the program is successful in distributing those vaccines, those countries will remain vulnerable to continued coronavirus outbreaks since most experts guess that at least 70% of people will need protection from the virus to reach herd immunity. And experts have noted that even if richer countries reach some level of herd immunity, everyone will remain vulnerable as long as there are pockets of COVID-19 anywhere in the world. “We will not end the pandemic anywhere unless we end it everywhere,” said WHO Director-General Tedros Adhanom Ghebreyesus. “Today is a major first step towards realizing our shared vision of vaccine equity, but it’s just the beginning. We still have a lot of work to do with governments and manufacturers to ensure that vaccination of health workers and older people is underway in all countries within the first 100 days of this year.” The vaccines delivered Wednesday are the first of some about 7 million doses being produced by the Serum Institute in India for some 20 countries, according to the Africa Centres for Disease Control and Prevention. “Over the coming weeks, COVAX must deliver vaccines to all participating economies to ensure that those most at risk are protected, wherever they live,” said Dr Seth Berkley, CEO of Gavi. “We need governments and businesses now to recommit their support for COVAX and help us defeat this virus as quickly as possible.” ___ Petesch reported from Dakar, Senegal. Associated Press writers Maria Cheng in Toronto and Jamey Keaten in Geneva contributed. from https://ift.tt/3aQu3pK Check out https://takiaisfobia.blogspot.com/ |
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