This week Fred and I discuss positive impact vaccines are having beyond the basic prevention of disease that includes a 50% reduction in transmission of the virus in those people who have been vaccinated. The importance of being fully vaccinated even if you have had COVID19 in the past.
And we review SARS-CoV-2 and the number of variants emerging, which in this case is no more than expected but seems higher because we are witnessing evolution in real time with a front row seat. We discuss the concern of the rise in variants which as a result of the evolutionary pressures of the widespread circulation of SARS-CoV-2 in the human population. The large number of cases has favored the global emergence and the natural selection of several variants of concern.
For those interested the UK has an excellent resource for tracking these variants
If you need additional help or support getting back to work and school safely reach out via the website
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here working with employers to help their employees improve their health and look at their overall employee health benefits programs. So one of the areas, Nick, that’s been interesting has been this idea of get everybody there to shots as quickly as possible, or kind of spread them out, which I believe was the UK strategy around this. So I understand there’s a preprint article out discussing that. What’s that show? Yeah. So
Nick van Terheyden
just to be clear, UK strategy, UK guessing strategy a little bit, there wasn’t a tremendous amount of scientific data to support it. But actually, at one out, it proved to be very effective. I think the UK has done a good job, thankfully. But you’re right, one of the things that we’ve really struggled with in this pandemic is okay, so you get vaccinated, we know it protects you. We know it’s not 100%, we’ve discussed all of those issues. And yes, you can be vaccinated and still get the disease, but it prevents you from getting severe disease, and, you know, from dying from the disease, and has all sorts of you know, additional side benefits. But the critical piece here is does it prevent the transmission of the disease to other people. And thankfully, the UK has done a good study, it’s pre published. So it’s not being peer reviewed, but it was reviewed in nature. And essentially, they demonstrated a very clear reduction in household. So a great way of assessing this, you looked at people that got infected where they had a spread of vaccination, maybe you know, some individuals that were vaccinated or not depending on age, and so forth. And they demonstrated that it reduced the spread of the disease by at least 50%, after one dose of a two dose regimen. So that means intuitively, not based on science, but sort of thinking about the science and how these things work and the elevation, the booster dose. But if you had two doses, that number might actually rise. But a 50% is great news. So good news, you get vaccinated, you’re less likely to spread the disease. And if you wanted another data point to suggest why that might be the case, or you know, supporting evidence, just look at Israel, the signals in the Israeli data were, you know, they went after this, you know, did a solid job of getting through the population, and you saw this really big steep decline, that couldn’t just have been about preventing the disease in the first instance, it had to include some of this. So now we’ve got some good data on it.
Fred Goldstein
Fascinating. So I know in the United States, actually, it’s interesting, because there have been a whole ton of folks that apparently haven’t gotten their second shot. So maybe a little better impact for us here. Although it’d be great to get that second one in.
Nick van Terheyden
Yeah, let’s be clear, there’s the the science, and the studies that were carried out showed this, you know, basically incredible positive impact of the second dose with the exception of the Johnson and Johnson Janssen vaccine, which was designed as a single dose and, you know, performs equally well based on their data. But if you’re in a two dose regime, you should make sure you get that second dose, because it’s just going to give you additional benefit. Before we move on from that, why are people going not or not going for that? You know, you’ve seen a little bit of that, Fred, right. I mean, the the responses? Well, I don’t want to get sick, and I’m hearing all this, you know, people get really unwell. Well, have you had your second dose? Yeah,
Fred Goldstein
I certainly did. And certainly did. And I was one of the ones actually, because I’ve been reading about this, I was one of the ones that had no impact.
Nick van Terheyden
No, you’re not one of the walls? No.
Fred Goldstein
Yeah. Which is interesting. And they’re out doing some studies on why this is that some people have a much more severe symptoms from the second shot versus the the or the or from the first as well as we’re have none. And, you know, they’ve said clearly the immune response is still there. It’s just different, you know, and in terms of how your body is impacted by those shots, so I feel pretty good. I’ve gotten the two in, I would hope people would continue this. There’s another interesting study about this, that it’s not just singularly people worried, like you said about the about, oh, I’m going to get a the second one’s going to impact me more severely, and I don’t want to deal with that. There’s also urban versus rural issues. There’s democrats versus GOP issues. There’s Some racial differences in willingness to get the shots. So it’s really going to take a multifaceted approach to try and get enough of these vaccines into individuals now, as we’re seeing big surplus in supply, and a dropping demand for shots, which we really didn’t want to see,
Nick van Terheyden
yeah. So we need to match up that we’ve got great supply, let’s get that supply used. And then in the case of the supply that is unused, or maybe can’t even be used, so AstraZeneca as an example, let’s get that made available to as many people as possible. I think the science and the data is very clear on AstraZeneca. Yes, there is some increased risk, but disproportionate in terms of the effective, it would be very clear if I was offered the AstraZeneca vaccine, which I can’t because I live in the United States, I would absolutely take it. I consider it a safe vaccine based on the data and all of the work that’s been done today.
Fred Goldstein
Fascinating. And the other issue I think you want to discuss was variant set, right?
Nick van Terheyden
Yeah. So I think the thing about the variance is that we’re just getting this front row seat to, you know, full on evolution in real time, which is a an incredible thing. So that’s a testament to the just coordination contribution of people. If you want to look at the variance, there’s actually a really good website that’s been put up in the UK, that sort of tracks the variance in real time, there’s a whole naming convention with these things that we haven’t even established is problematic variants of concern. You know, the numbering and of course, people have tied them to places and place names, because it’s easier to remember that we really shouldn’t do that. But here’s the thing, because we’ve allowed for this evolution to occur in real time, we’re not seeing any more mutations in this virus. In fact, it’s not at the high end of, you know, highly mutating and producing all these variants. And by the way, lots of them just disappear, because they don’t do them any good. But the more you do that, the more opportunity there is for something positive to emerge. And that’s essentially what’s happening. So it’s this unchecked spread of COVID. To that is occurring in parts of the world, we’re seeing this, you know, terrible devastation is essentially allowing for this global emergence of, you know, naturally selected variants that are better at transmitting and better at causing disease. Now, to be clear, the virus doesn’t have a brain and it doesn’t think about this, it’s sort of, you know, this evolutionary thought, doesn’t say, All right, I’m gonna go develop this thing. It’s sort of part of this random process. But evolutionary selection selects for those things, because it sort of determines, but it’s not necessarily the most lethal because, you know, the perfect virus doesn’t kill people. And in fact, we’re just sort of sit there and spread because it wants to survive. Because once it disappears, it’s no longer in existence, through through.
Fred Goldstein
And that that leads to an interesting article I read, which was in The Lancet, and sort of take a look at this broader issue of Do you take an elimination strategy and hammer everything? Or do you just seek to mitigate the disease and the article is entitled SARS, COVID, to elimination, not mitigation creates the best outcomes for health, the economy and civil liberties. It was just published on April 28, by Miguel olio, bartone, and, and a bunch of other folks. And essentially, they looked at this issue of the trade off between public health, economic growth, you know, community solidarity and civil liberties, and determined that those countries that chose to try to eliminate the virus and really hammer it, and had good community support, etc, actually, economically do better, because they’re able to get their economy regoing much sooner, and not have to have this ongoing issue of trying to deal with this virus in different places and communities. So it’ll be interesting to see is this data comes out more and more. But it also leads to the point you talked about those countries that have a mitigation strategy, like we’re seeing within your Brazil, United States, are essentially putting others in the world at risk because of these variants you talk about and the opportunity for a lot of people to get infected and create variants. And so it also talks about the need for a global health strategy, which is something I think we really need to begin considering around this. And you’ve talked about he just mentioned getting these vaccines to other places.
Nick van Terheyden
Yeah, this is not a country problem. And it’s not a local problem. This is a worldwide problem. And I think you bring up a great point, Fred, as we sort of move past the, you know, the, the nexus of this and you know, hopefully at some point in merge and you know, we’ve suppressed this virus, we need to have a better sort of coordinated strategy with all countries signing on. This is this is the protection and I find that interesting. I mean, we can’t go back and fix that at this point. It’s too late for this one. But if you think this is the last It ain’t we’ve had, you know, at least two previous coronaviruses you know, or not pure Coronavirus, but there are other coronaviruses. And we’ve had other potential pandemics, which didn’t impact us as much, fortunately, but I think we have to have a much better coordinated, international response that everybody agrees to and
Fred Goldstein
share the load. Absolutely. And with that, this is Fred Goldstein with the cannibal health thank you so much for listening. If you’d like more information or to reach out to us, you can go to a cannibal health LLC calm.
Nick van Terheyden
And this is Dr. Nick on the incrementalist here with incremental insights for better business, better health.
