[COLUMN] COVID-19 updates

ITALY, “the first western country to be severely hit by the COVID-19 pandemic is also the first nation to face a third wave of COVID-19 and now re-imposing a strict nationwide lockdown a year and more than one hundred thousand deaths later.” There has been six weeks of increasing COVID-19 cases, attributed to people lowering their guard, especially young people who refused to wear mask and do social distancing. The preventive value of masks and social distancing has been proven beyond doubt around the world. There are about 3.3 million cases of COVID-19 in Italy, with around 103,000 deaths. Let us all behave wisely and responsibly. Hopefully, we would have herd immunity by the end of summer.
Worldwide, there are more than 120.5 million cases and almost 2.7 million deaths; more than 30 million cases in the U.S. with about 548,000 deaths; and, in the Philippines, around 627,000 cases and almost 13,000 deaths.
AZ vaccine and blood clots
Some countries have temporarily ceased using the AstraZeneca vaccine after some patients developed blood clots, post-vaccination. According to the Washington Post, “AstraZeneca said that of the 17 million people so far inoculated with its vaccine, jointly produced with Oxford University, there have only been 15 cases of deep vein thrombosis and 22 pulmonary embolisms. This is much lower than would be expected to occur naturally in a general population of this size and is similar across other licensed COVID-19 vaccines.” Clinical analysis is ongoing.
Zinc and COVID-19
Zinc is an important element needed by our body to maintain good health. It helps boost the immune system and aids in the production of protein and the DNA. Zinc is also one of the ingredients used in the treatment of COVID-19. A recent study found that “participants with low zinc levels had a 21% mortality rate compared with 5% in those with healthy zinc levels; the time to clinical recovery was approximately three times less in those with healthy serum zinc levels; and the authors concluded that serum zinc levels could help predict the outcome of individuals with COVID-19.” Consult with your attending physician before taking Zinc or any other medications.

Comparing the vaccines

Everyone is interested to compare the three vaccines currently used in the U.S. Here is last week’s comprehensive report from Kristina Fiore of MedPage, a consumer medical publication circulated to the medical community.

Company: Pfizer/BioNTech
Vaccine name: BNT162b2
Mechanism of action: mRNA vaccine
Dosing schedule: Two doses, 21 days apart (30 μg/dose)
Efficacy: 95% at least 7 days after dose 2.

Illness was defined as having a confirmed positive COVID-19 test and at least one of the following symptoms: fever, new or increased cough, new or increased shortness of breath, chills, new or increased muscle pain, new loss of taste or smell, sore throat, diarrhea, or vomiting.

Research trial participants: 43,548 people age 16 and up.

Side effects: Most common were fatigue and headache after both doses, with both being more prominent after the second dose. These were milder for participants over 55 compared with those age 16 to 55. In this latter group, the rates of fatigue and headache were 59% and 52%, respectively, after dose 2.

Storage: Ultra-cold freezer required, -112ºF to -76ºF (-80ºC to -60ºC) for up to 6 months; FDA recently agreed to allow storage of frozen, undiluted vials at standard pharmacy freezer temperatures between -13ºF and 5ºF for up to 2 weeks.

Variants: No clinical data; lab studies have shown that the South African (B.1.351) variant may reduce antibody titers by two-thirds. Pfizer is studying a third “booster” dose of the original vaccine against this variant, as well as evaluating a variant-specific vaccine with a modified mRNA sequence.

Number of doses contracted by the U.S.: 300 million.

Company: Moderna
Vaccine name: mRNA-1273
Mechanism of action: mRNA vaccine
Dosing schedule: Two doses, 28 days apart (100 μg/dose)
Efficacy: 94.1% at least 14 days after dose 2.

Illness was defined as having a confirmed positive COVID-19 test and at least two of the following symptoms: fever, chills, myalgia, headache, sore throat, new olfactory or taste disorder; or at least one respiratory sign or symptom including cough, shortness of breath, or clinical or radiographic evidence of pneumonia.

Research trial participants: 30,420 people age 18 and up.

Side effects: Overall systemic adverse events including fever, chills, headache, and myalgia were recorded in 60% of participants after the first dose and in 80% of participants after the second dose.

Storage: Frozen between -13ºF to 5ºF (-25ºC to -15ºC); can be stored refrigerated from 36ºF to 46ºF (2ºC to 8ºC) for up to 30 days prior to first use.

Variants: No clinical data; lab studies found no significant impact on neutralizing antibodies with the U.K. variant (B.1.1.7) but a six-fold reduction in neutralizing antibodies with the South African variant (B.1.351). Moderna plans to test a variant-specific booster candidate, a multivalent booster candidate, and a third dose of the original vaccine at 50 μg.

Number of doses contracted by the U.S.: 300 million.

Company: Johnson & Johnson/Janssen
Vaccine name: Ad26.COV2.S
Mechanism of action: Adenovirus vector vaccine
Dosing schedule: One dose (two-dose regimen under evaluation)
Efficacy: 72% in the U.S. and 66% globally against moderate-to-severe disease; 85% effective against severe disease, 28 days after a single dose.

Moderate illness was defined as a confirmed positive COVID-19 test plus one more of the following: evidence of pneumonia, deep vein thrombosis, shortness of breath or abnormal blood oxygen saturation above 93%, abnormal respiratory rate (≥20); or two or more systemic symptoms suggestive of COVID-19. Severe illness was defined as a confirmed positive COVID-19 test plus one or more of the following: signs consistent with severe systemic illness, admission to an intensive care unit, respiratory failure, shock, organ failure, or death.

Research trial participants: 43,783 people age 18 and up.

Side effects: Most common systemic reactions were headache (39%), fatigue (38%), myalgia (33%), nausea (14%), and fever (9%).

Storage: Stable for 2 years at -4ºF (-20ºC) but can be stored for at least 3 months at typical refrigeration temperatures of 36ºF to 46ºF (2ºC to 8ºC).

Number of doses contracted by the U.S.: 100 million.

Hundreds of millions of the COVID-19 vaccines have been administered around the world and they have been found to be safe and effective. The medical reality is that those who refused to get the vaccine would have the greatest risk to get infected and potentially succumbed to the virus. Life is precious!

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The opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of the Asian Journal, its management, editorial board and staff.

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The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.

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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: philipSchua.com and FUN8888.com; Email: scalpelpen@gmail.com.

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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