Thoughts of a retired physician

  For the next current events session here at MonteCedro, the group wanted to discuss pandemic preparedness. Since both Margan and I are infectious disease physicians and epidemiologists who were involved in preparedness planning for many years in both military and civilian organizations, this will probably be fairly easy. I thought it might be useful to write a little about how this important topic came to be and, in light of the Covid-19 pandemic, what went wrong. Pandemics are a relatively recent problem. In human history, only in the last 10,000 years have we had the conjunction of agriculture, which fostered larger populations of more sedentary humans, along with constant contact with domesticated animals, whose microorganisms we came to share in a variety of ways. Tuberculosis and measles originated in bovine animals. Influenza is primarily a disease of fowl and pigs. Human immunodeficiency virus (HIV) arose in nonhuman primates in Africa and likely spread to humans through c

  In December 2020, the FDA issued emergency use authorization for two unique mRNA vaccines to deal with the Covid-19 pandemic. Both the Pfizer-Biontech vaccine and the Moderna-NIH vaccine were spectacularly successful in large Phase 3 clinical trials in preventing severe disease, hospitalization, and death from Covid-19. Furthermore, the safety profile of both vaccines was impressive. This was tremendously good news. Even so, negative press about these vaccines soon followed and unfortunately continues to this day.  In the United Kingdom, which began vaccinating before the U.S., there were several early reports of anaphylactoid reactions . Soon after vaccinations began in the U.S., similar reports occurred. CDC looked at these and found a rate of 11.1 cases of anaphylaxis (none fatal) per 1 million first doses of the Pfizer vaccine. Anaphylaxis is reported with many other vaccines and usually occurs within 30 minutes of receipt of the vaccine. It is treatable with epinephrine. Th

  After the presentation of overwhelming evidence of Donald Trump’s incitement of a mob that invaded the Capitol, sought to harm or kill elected officials, and wanted to overthrow the U.S. government, 43 Republican Senators decided that their political party and continuing power was more important than their country, the Constitution, and the oath they swore to defend that Constitution against all enemies, foreign and domestic. Trump is a domestic enemy. Shame on them and may they be damned forevermore as the traitors they are.

  Vaccines to prevent disease from SARS-CoV-2, the cause of Covid-19, are being administered at a slow but increasing pace in the United States. As of 6 February, over 59 million doses of vaccine have been distributed and about 66%, a little over 39 million of that number, have been administered. The trendline for vaccine administration remains rising and the 6th of February marked the first day that more than 2 million doses were administered. Because the approach taken by the Trump administration regarding vaccination ended with delivery of vaccine to each state, the struggle for the almost 2 months of how to get vaccine into arms has fallen to local and state governments which were already severely impacted by the pandemic. While we are doing better than at  the start, we need faster administration into the arms of people to protect them and blunt Covid-19 transmission. Joe Biden’s administration hit the ground running on January 20th. His Covid Response Team worked for months to