Covid-19 vaccines began last week for everyone over 75 in Massachusetts. The state distribution program includes websites to sign up, outreach calls from major health care organizations and pharmacies, and a new 211 call center. Most all elders should be started on vaccination this month and finish by late March. The over-65 population and younger people with several comorbidities will follow. When younger, healthy populations get vaccine late Q2 will depend on vaccine supply. While there remains lots of uncertainly, the roll-out seems to be working and even improving. Stay calm.
We use available state Covid-19 infection rates and other published data together with the binomial distribution to calculate the risk of unsuspected infections in small group gatherings. With our current high level of infections (20 times higher than summer) the risk is 5-10% for groups of 10 or 20. You DON’T want to gather indoors with other than household members this winter.
Two monoclonal antibody treatments are conditionally approved by the FDA, seem to substantially help moderately severe cases of Covid-19, and are supposed to be available for use as outpatient infusions to prevent hospitalizations and deaths. In practice they are not actually available, as I found out this weekend trying to arrange an infusion for a patient. This is another fail of our health system.
I explain multiple and sometimes complex issues with the Covid-19 epidemic, starting with where we are in the infection epidemiology (new infections in Mass. are leveling off but are still high, deaths are growing). Then I explore the types and efficacy of biological tests (PCR and antibody), and why different people have different personal Covid risks and may make appropriately different responses in behavior and personal protective equipment. I tried to keep it short, but ultimately chose clarity over brevity.
The next six weeks will be risky for all of us as the Covid-19 epidemic continues to extend its reach. Nevertheless, I am convinced we can all stay safe with a high degree of probability during this time, whether by keeping in our circles of safety, or by careful use of personal protective gear, providing we are rigorous in our self-protection. I present and explain a graphical model of how and why the number of active cases will likely increase and by how much over April and May.
Today marked beginning of the third week of our collective quarantines. Our practice has had just several possible or likely cases of Covid-19. We will be in “lockdown” certainly through April and most likely through May. We are not providing any off label treatments at this time. Much more testing of active and past disease is needed to enable us to eventually come out of quarantine safely, as well as face masks for all. These of course are not available as yet. But a good card game to try is.