February 1st, 2021 COVID-19 UPDATE
Given the rapidly changing solution, here is a quick follow up blog to update readers and non-scientists or non-medical personnel on what is important in our battle against SARS-Cov2.
Coronavirus cases in the US hit 26.5 million although it is likely that a much larger number actually got infected and was asymptomatic or mildly symptomatic and did not know or did not get tested. Globally, greater than 100 million cases were recorded. Deaths globally exceed 2.25 million, and in the US, greater than 450,000. We are gradually approaching 500,000 deaths in the US, the highest number of deaths anywhere.
This is clearly due to lack of a plan and consistency of guidelines and politicization of a pandemic that has killed so many and destroyed so many families. Hospitalizations are falling as are new cases. Deaths and hospitalizations are lagging indicators, but it appears that deaths and cases have peaked for now.
New York will be allowing indoor dining on Valentine’s day while California is lifting lockdown restrictions. On the vaccine front, about 1 million vaccinations have been done daily for the past 11 days. About 29 million vaccinations have been done in the US thus far without any reported deaths or major adverse effects although health insurers and hospitals are preparing for admissions in case of adverse effects.
The big news on the vaccine front with Novavax coming out with their trial results shows a 95.6% efficacy against the original Covid-19 strain and 89.3% effectiveness against the UK strain. However, like the other vaccines, its efficacy against the South African strain was only 60%. This remains a challenge and a problem but the vaccine makers, Moderna, Pfizer and Novavax have plans to tweak the vaccine or design new mRNA vaccines to address the South African or Brazilian variants and is likely that a full-fledged clinical trial with 15,000 to 30,000 volunteers will not be necessary to prove efficacy against these variants.
Kudos to our scientists and health care workers. For those of you who still think Covid-19 is a hoax and refuse to wear masks, perhaps if you develop Covid-19, you should not use our health care system or our health care personnel as you put them and your families and friends at risk. Of course, I am being facetious, but it is getting tiresome to listen to these folks. A patient after being admitted to the ICU for Covid respiratory distress syndrome, informed his physician that he should find another diagnosis for Covid as he did not believe in Covid.
There has been plenty of stupidity from both sides of the aisle during this pandemic. Eventually science has won. And if you do not believe in our science, as convoluted the path may be, perhaps you should not be driving your cars or using anything that has emerged from science.
On a clinical note I had a patient recently that had Covid-19 three weeks ago who was treated with antibiotics, steroids and vitamin D, zinc, vitamin C, etc. and quarantined for 2 weeks. He came to my office recently with a severe sinus infection, sore throat, fever, ear infection and a little shortness of breath. He thought that he had strep throat given that he had just recovered from Covid. I found fluid behind his ear drums with hearing loss and on nasal endoscopy had pus coming out from his sinuses. A rapid test came out strongly positive. Covid can cause sinusitis and ear infection and can mimic acute sinusitis or strep throat. That means he developed a second infection within 3 weeks of his first infection!!
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Is it possible that he has been infected by the UK or South African Variant after being infected by the original coronavirus?? Novavax recently showed in their South African trial with their vaccine that patients who had the original coronavirus infection could still get the South African Coronavirus infection and that their vaccine protected these individuals by about 60% from getting the second infection from the South African variant. I recommended that he be seen at a tertiary hospital for antibody treatment and for sequencing of the virus. More important, unlike the cold chain and freezer needs for the Moderna and Pfizer vaccine, Novavax requires refrigeration only. NOVAVAX VACCINE APPEARS TO BE THE BEST VACCINE THUS FAR, BOTH IN EFFICACY AND COLD CHAIN STORAGE.
AS PHYSICIANS AND SCIENTISTS, WE ARE STILL STRUGGLING TO UNDERSTAND HOW OUR BODIES RESPOND TO THIS INFECTION AND WHY IT IS DIFFERENT BETWEEN DIFFERENT INDIVIDUALS AND WHY SOME ELDERLY DO WELL WHILE SOME YOUNGER ONES WHO ARE APPARENTLY FIT AND HEALTHY AND EXERCISE REGULARLY SUCCUMB TO THIS DISEASE. SOME OF MY VERY HEALTHY COLLEAGUES HAVE PASSED AWAY.
STOP TELLING US THAT THIS IS A HOAX. GET WITH IT. DENIAL OF FACTS AND EVIDENCE IS NOT A BIRTHRIGHT NOR YOUR UNBRIDLED RIGHT TO EXPRESS YOURSELF. AS EINSTEIN SAID, AND I PARAPHRASE, “I DO NOT KNOW IF THE UNIVERSE IS INFINITE, BUT I DO KNOW THAT HUMAN STUPIDITY IS”. TAKE CARE OF YOURSELVES AND YOUR LOVED ONES. STAY SAFE AND GET VACCINATED EVEN IF WE DO NOT KNOW HOW LONG THE VACCINATION INDUCED IMMUNITY LASTS OR ITS SIDE EFFECTS. BY THE TIME WE GET TO KNOW, MANY MORE MAYBE DEAD. WE CANNOT KEEP THE COUNTRY, THE WORLD OR THE ECONOMY SUFFERING LIKE IT HAS THIS PAST YEAR.
UMANG KHETARPAL, M.D.
Dr. Umang Khetarpal finished his medical school at the young age of 22 and is trained in Otolaryngology-Head and Neck and Facial Plastic Surgery. He completed his internship and specialty residency training in Syracuse, New York. He also has extensive research experience and additional clinical experience through fellowships at Massachusetts Eye and Ear Infirmary and Brigham and Women’s Hospital, Harvard Medical School in Boston. He has co-authored book chapters and many publications in peer reviewed journals within the specialty. He has presented at major specialty society meetings and at academic institutions. Topics of his research included hearing loss and balance disorders, sinus problems and sleep apnea. His recent research efforts have been entirely focused on sinusitis, especially recurrent acute rhinosinusitis, allergies and in office balloon sinuplasty and in office sinus surgery. He has recently presented five papers at the International meeting of Rhinology in CHicago, June 2019. He discovered and was the first to describe a novel ear disease in families that resulted in balance and hearing problems. His most innovative research was in the cutting-edge field of genetics in Otolaryngology where he was involved in finding the genetic defects for several different diseases. In addition, he has taken time to observe the surgical techniques of some of the world’s most renowned surgeons in plastics surgery. He had been featured 3 times over the years in newspapers in the Rio Grande Valley for introducing latest treatments in thyroid cancer, sleep apnea and sinus surgery locally. His current interest is in molecular genetics of allergic rhinitis and chronic sinusitis with and without polyps and in finding better cures for these conditions. He now calls Houston his home and is starting his practice in the Woodlands.