Up-to-date on Coronavirus.
Maxime Coles MD (February 2021)

The vaccines have been developed to protect against COVID-19 but it differs from the traditional vaccines because they do not inject a life or a deactivated part of the virus into the body of the recipient. The laboratories worked on a manufactured genetic material called messenger RNA (mRNA) to instruct the body cells for manufacturing spike proteins, the same protein found on the surface of the virus. As such, the vaccines are incapable of transmitting the disease.

More than 100,000 pregnant women have already received the COVID-19 vaccine.  So far this has shown no serious side effects. The question whether a pregnant woman or a nursing mother was able to receive any actual mRNA vaccine has been answered.  Again, these vaccines do not contain any live virus and as such can’t transmit the virus. There are only limited data about the administration of the vaccine mRNA to pregnant and lactating women. The Moderna vaccine appears to be the one the CDC favored for the women.

It has been reported recently that pregnant women infected with the coronavirus were found to have a higher chance of dying from the disease. Sanofi told us that their failure to produce a vaccine like the competitors was due to a faulty reactive agent. They will take at least six months prior to produce their vaccine. For such a big French company, it is embarrassing to see Pfizer-Bio-N-Tech, Moderna and Astra-Zeneca perform so well especially when researchers have found out that the vaccine was slowing down the transmission of the virus.

Indeed, there are some side-effects of any vaccine and we can’t put then aside. At the site of the vaccination, swelling or redness may be observed but it is expected to go away in a few days. There may be some systemic reactions as well like fever, chills, headache, nausea, vomiting, tiredness or muscle aches. These represents signs that the vaccine is working. It will be extremely rare to find an allergic reaction which can threat the life of the one receiving the vaccine. You may be allergic to latex or polyethylene glycol used as an ingredient to the actual vaccine. The CDC unequivocally recommend the vaccination. We should avoid painkillers around the time of the injection and let the vaccine stimulate your immune system.

I heard my patients asking if the vaccine were able to give any orthopedic problems. Since most vaccines are injected into the deltoid muscle, patients had questions about shoulder injuries which generally will rarely happen. A sub-acromial bursa can show signs of inflammation; a rotator tendonitis can be also a finding related to an injection perhaps ill performed. They rarely can become a consequence of the injection itself especially when our healthcare professionals are used to vaccinate people.

Meanwhile, CBS reported protests at a Los Angeles mass vaccination site. Protesters exhibited signs stating that COVID-19 was a scam while claiming the vaccine dangerous. The demonstrators were urging people to refuse to take the vaccine, stop wearing masks and avoid testing against the disease. Hopefully most of the people in the lined up, were eager to receive their first dose after having waited for weeks to see it happen. We know well how Los Angeles area has been hit with high number of new cases (5900), hospitalizations and deaths. The state of California has reported more than 3.2 million cases and near 41,000 deaths (1/1000 Californians). The contagious strain especially the British B.1.1.7 strain has been identified.

During the meantime, an Australian Company Ellume is ready to sell to the United States a new home virus testing kit for a 230 million deal. The FDA has already approved the deal last month. Although there are other kits available on the market but this test is the only one which does not require a prescription and the results can be available within 15 minutes via smart phone/Bluetooth.

These kits are being shipped as of the first of February 2021 until the company establishes a plant in the USA. These kits use a sterile nasal swab, a pressuring fluid and a testing strip, connected to a smart phone at a cost of 30 dollars online or in drugstores. The question remains if the medical insurance will cover the cost.

The CDC continues to implement the wear of face masks in any public place for people older than 2 year-olds. We need to face the reality that many want to refute. Public places like trains and subways stations, airport, taxis, buses, stadium etc. need to keep our attention. People have to understand that such measures can allow us to safely travel and bring confidence to the workplace. It is encouraged to disembark any person not complying to the rules. More than 90,000 COVID-19 related deaths have been recorded during the month of January 2021 and 77,000 in December 2020 but in total, almost 26.5 million infected cases and more than 441,000 deaths in the USA while more than 104 million cases and more than 2.3 million of deaths have been recorded worldwide.

Let us stop pretending. Wear one or two masks if possible and stay 6 feet apart, avoid crowds and wash your hands as often as you can. Keep politics out of the equation. This virus SARS-CoV-2 is there to make us pay a heavy price. Let us encourage a wider vaccination campaign. in the United States of America so we can reach that herd immunity or at least that state of protection against this pandemic.

This corona virus has surged in the US after almost every major holiday Memorial Day, Labor day, Thanksgiving, Christmas. Let us hope that the Super Bowl next Sunday will not follow the trend. The recent variant detected in the UK is already becoming the most dominant strain in many other countries included the United States of America. It is believed that at this rate more than half of the new infected cases may be due to the B.1.1.7 variant in the next two or three months.

At the beginning the clinical outcome of individual infected by this new UK strain were thought to be similar to the infected cases with the other strains, but clinicians have changed their opinions and believed that the B.1.1.7 victims may have a 30% increase in the death rate. This change in the picture will require dramatic changes against the COVID-19 new mutations.

Less than 1000 cases of this new variant have been already localized in more than 30 states since December 2020, according to the CDC. Unfortunately, a normal coronavirus test is not sophisticated enough to differentiate the variants because this can be done only through a genomic sequencing. One at the CDC is comparing this new strain B.1.1.7 infection to a category “5” storm.

Let us be ready because the worse is yet to come. What is encouraging for the country is the fact that the number of new US cases of COVID-19 for the first time, dropped below 100,000. especially after what we have witnessed after the post-Thanksgiving hospitalizations and death spike.  3,000 people are dying every day while 80,000 Are hospitalized and a recent article states that the number of cases is underestimated in the United States.

Maxime J-M Coles MD

Boca Raton FL (2-9-21)

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