Interview with the Mayor of Frederick on COVID-19 and its impacts on the city

This is an interview with the Mayor of the city of Frederick (Maryland), Michael O’Connor. We discuss the challenges of COVID-19 and its effects Frederick, MD


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Regeneron’s new antibody cocktail therapy for high risk category patients proves effective

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Regeneron has released their antibody cocktail for treating mild to severe cases of COVID-19. Their antibody cocktail consists of casirivimab and imdevimab both of which are monoclonal antibodies which when given together have been shown to have significant anti-viral activity against COVID-19 for patients who are in the high risk category (defined extensively here) for having deleterious effects. Some of the high risk category patients are those who are immunocompromised, older adults (>65) or older adults above 55 years of age who have certain ailments such as respiratory diseases such as COPD, heart disease or hypertension to name a few. Youngsters are part of their high risk category too, anyone from 12-17 who may have chronic heart issues or other serious chronic diseases. The idea here is simple, anyone with a serious disease that puts their immune system at risk is a good candidate for these cocktail drugs.

How do these drugs work? If you look at the ending of the names of the two drugs in the cocktail you can see that they end with vimab. This tells us that they are virus specific (VImab) monoclonal antibodies (viMAB). Antibodies are part of your immune system. When your body gets presented with anything that shouldn’t be there like say a common cold virus, the circulating B cells in your body will come into contact with the offending virus (antigen). This contact stimulates the B cell to turn into a plasma cell which produces specific antibodies against the specific antigen, in this case a common cold virus. The contact of the B cell with the antigen also triggers an event that causes T helper cells (also part of the immune system) to come and attach to the B cell further stimulating the B cell to divide itself and make more plasma cells. More plasma cells means more antibodies will be produced. So in essence the B cell is a military recruiter/drafter/boot camp that helps make soldiers (antibodies) against the offending antigen (the enemy). The antibodies that are made your body are very specific against the antigen that it is trying to overcome. Once antibodies are made towards a certain antigen, it is memorized by a type of B cell called memory B cells, which remember what a specific antigen looks like should you be exposed to it again. People who are immunocompromised cannot count on their immune system to provide the protection I just outlined. This is where the cocktail of antibodies come into play, they help provide the support your body needs to mount the attack necessary against COVID-19.

For this particular antibody cocktail to work the way it is supposed to, you need to give it to the patient before the disease has progressed too far. The idea is to give it to these high risk patients as soon as they come up positive for virus hopefully before disease progresses too far. The idea is to mobilize an army before the enemy hits, makes sense right? As Regeneron puts it, if you are already on high flow oxygen or some sort of ventilation then this drug is not the best for you (whether they established this through their study or don’t have enough data to know this is still unknown to me at this time).

The antibody cocktail are very highly specific to COVID-19 and are produced in cells that are highly characterized. The cells being used to make the antibodies were made using one single isolated clone cell, therefore we know that each and every subsequent cell made from it will be an exact clone and the fore we can be sure of the quality of the products it makes. The antibodies made in these type of cells are known as monoclonal antibodies. The cocktail of antibodies attach to a part of the virus that prevents its ability to attach and therefore not be able to enter human cells.

Antibody therapy is not new, it’s been been around for quite sometime. Look for those TV ads that advertise them, they end with the letters MAB indicating they are monoclonal antibodies As the drugs have been released under the FDA emergency use provision more data will come in as we use the drug as to whom the drugs have the most positive impact on. President Trump was administered this drug when he was diagnosed as having the virus a month ago. The timeliness of the administration of this cocktail of antibodies indicates even more the importance of testing for COVID-19 especially if you are in the high risk category. The impacts on COVID-19 positive patients who are otherwise healthy and are not in the high risk category is something that needs to be evaluated but in the meanwhile, these drugs are available to those who are most highly likely impacted to a greater degree than the average healthy individual.

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Ear Piercing in the Time of Pandemic

My younger daughter got her ear pierced at the local mall, check out the YouTube video detailing that event.

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mRNA vaccines: Concept of the future to reality in 8 months

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mRNA vaccines were always a promise of the future. They would be easy to produce and can be made rather quickly. Not that long ago, the promise of an RNA vaccine coming into fruition was still a few years away, progress wasn’t slow but there was no urgency, we would take our time to study this innovative concept and roll it out eventually. We would study this concept out of science fiction and explore every avenue of its benefits and potential issues before going into humans. All that has changed with COVID-19 being introduced to the world which as we all know has resulted in a pandemic. Suddenly no stone was left unturned, in the vaccine space all techniques to shorten this burden on our lives were at play, including convalescent sera therapy (simply put, taking the plasma from a person who has had COVID-19 and has developed antibodies against it and putting it into someone who’s at high risk for it but hasn’t contracted the virus yet) which from an innovation stand was not that progressive, but it works. Pfizer and Moderna have both within days of each other have announced that their clinical trials of their respective mRNA vaccines produced safe responses in their participants. As the world waits to breathe a collective sigh of relief, the infection numbers surge out of control for a second time in the Western world with pockets of resurgence in the East. As we wait for FDA approval for these two miracle drugs, I wondered how did a concept that was moving at turtle pace suddenly beat the hare at the finish line?

To answer this you must understand how mRNA vaccines work. A traditional vaccine (one that most of you are afraid to take, including medical professionals (shame on them)) like the flu vaccine or shingles vaccines is designed to introduce to you a piece of the offending disease whether it is an inactivated virus or an antigen (a protein or fragment that resembles part of the virus). The idea is to get your body to elicit an immune response to the vaccine such that your body will create a memorable defensive response should you be exposed to the disease post-vaccine. Different vaccines have different durations of its ability to retain that memory in the body.

mRNA vaccines work by introducing mRNA (which is nothing more than a photocopy of the offending virus’s RNA (they don’t have DNA like humans, they work with RNA) into cells in the human body. When foreign mRNA is introduced to the body thanks to the vaccine, your body’s immune defenses wake up, while the mRNA is translated in the cell it produces an antigen (similar to the ones contained in traditional vaccines). In effect it’s using your body’s cells (a small amount) to turn them into factories to make the vaccine within you.

The safest part of all this is that your DNA is never touched. Because we are introducing a photocopy of the virus RNA into your cells it never touches your DNA, it already has all the instructions to tell the cells in your body to make the antigen without touching your natural DNA. The bad part? It’s not easy to store, that’s the part of the story where the progress of mRNA vaccines comes in, we have not gotten so far in the development of such vaccines to the point we thought about making it easy to get into humans (since until COVID-19 we were no where close to having one for clinical trials in humans and no approved mRNA vaccines exist at this point) and we never expected to deploy it at such an accelerated pace or require such high quantities at once. The Pfizer vaccine requires you to take two doses three weeks apart, not to mention it needs to be stored at -70C in -80C freezers (something your local CVS doesn’t necessarily have and found typically in labs). The Moderna vaccine also needs to be administered over two doses, four weeks apart, but can be stored at -20C, which gives it a slight advantage as these freezers are more typically around making it easier for circulation in areas where specialized freezers are hard to come by.

So how did a vaccine concept go from baby steps to being the contender for the first line of COVID-19 vaccines that will reach the American public in 8 months (closest record before this was four year)? It’s easy to make, all you need is a map of the virus’s RNA (the viral genome of the disease in question) and you can put together the basic subunits of your mRNA vaccine with ease. It is what probably motivated Pfizer and Moderna in the first place, it was a risk worth taking. With data from both their clinical trails showing positive news, it is expected that they will wrap up with FDA regulators within weeks to deploy this to the American public.

The novelty of the technology (which was nowhere close to being a real player anytime soon) juxtaposed against the need for a stopping block against the pandemic no doubt weighs on the conscience of the FDA and the CDC in their decision making process on the safety and the potential of the vaccine to prevent COVID-19 over time (efficacy). Necessity is the mother of all invention, and two pharma companies have delivered the calling. While we wait for other vaccines to deploy (and they will soon enough) we have no choice but to take a leap of faith with the confidence of safety from their clinical trails combined with their expertise of delivering safe drugs and products to their customers in the past. As the COVID-19 crisis goes into it’s second act, mRNA vaccines are poised to leapfrog into their first, hopefully transforming the way we prevent diseases.

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Maryland tightens grip on regs as COVID-19 surges

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The following stats caused Gov. Hogan to tighten the regulations governing capacity in business and public venues to curb the case count:

  1. The largest number of Maryland cases were reported on 11.17.20 at around 2,149 cases.*
  2. The number of days where there were more than a 1,000 cases was 13. *
  3. The state remained at 6.85% positivity rate.*

*Source

The Governor took the following actions based on the list above:

  1. Bars and restaurants to close by 10 PM
  2. Retail to drop back to 50% capacity from the current 75%
  3. A ban on fans at sporting events (college and professional)
  4. Ending visitations at hospitals and senior homes

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Happy Hour at a Friend’s House

Small socially distanced happy hour between two good friends, to keep contact minimum with the general public.

All photographs were taken with the Leica M240 and 50mm F2.0 Summicron Version III

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Frederick County’s Mask Mandate and other changes!

According to the segment by NBC Washington News there is now a mask mandate in Frederick County both indoors and outdoors where a six foot distance cannot be maintained. This matter on late Thursday night by the Frederick County Health Department.

In addition to this we got a definition of what the capacity limits are for different venues, here are the changes:

  1. Indoor/Outdoor Venues is limited to 25 people or 25%
  2. Religious Facilities at 50%
  3. Fitness centers at 25%

Unchanged:

  1. Restaurants and personal businesses at 50%
  2. Retail businesses at 75%

Stay safe out there, numbers are going up and we want to keep them as low as they were not that long ago in Frederick, MD.

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Happy Diwali from my family to yours!

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Thoughts on Pfizer’s COVID-19 Vaccine

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It looks like more than just the CEO of Pfizer is happy about the news (he sold a lot of stock to celebrate) that a study conducted by them showed that their vaccine candidate was more than 90% effective. This is welcoming news in a world that is tired of the pandemic and the effect it has had on their lives which is now in its 8th month. The infection numbers are going in one direction, up. The US is officially at 0.9% (don’t get caught up in the low percentage, it was 0.09% not that long ago, that’s a 10% jump!) infection rate of the entire population and as we approach flu season the numbers are dangerously on the rise.

While these early results are promising and a sign of good things to come, there are a few facts about this particular vaccine you should know so as to not tempt yourself into believing this will all be over in a month or two:

  1. The vaccine is a two dose vaccine, you will two shots, three weeks apart (good luck getting people to come back to take a second shot).
  2. You need to store the vaccine at extremely low temperatures (-80 C) a logistical nightmare for your local CVS.
  3. It’s a relatively small study at 94 participants (not bad and we need to accept smaller populations to test on given it’s a pandemic but it is still small!)
  4. I wonder what the FDA will accept as a demonstration of safety before rolling out to the population
  5. That brings me to my last point, who’s going to get the first doses? Will they want them if they are released with the FDA applying pandemic time regs?

The vaccine study is a great start considering where we were 8 months ago, but there will be more to follow and we will hit critical mass at some point but Pfizer’s early lead will help the FDA figure out just what is safe in these extraordinary times and will tell us can a small population represented in the study really account for what the vaccine will do in a large population? In the meanwhile the race has begun, this will hopefully go down in history as the milestone that humanity measured as when the pandemic turned on its head.

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Flu vaccine

Quick and fast, the vaccine was administered in less than 60 seconds!

While you wait for your COVID-19 shot, get your flu shot! Flu is a killer too. I got mine at CVS and it was free when I produced my insurance card. People ask me when a COVID vaccine’s going to be ready, I always reply with do you take the flu shot every year? Because if the answer is no to that then you don’t have to worry about COVID-19.

It’s amazing how much of the general population have a great aversion to vaccines. Last week’s 60 Minutes segment on COVID-19 interviewed General Gus Perna where he expressed one of his many concerns that people will not take the vaccine they are working so hard to stockpile and distribute in a controlled, scientific and strategic manner.

His final words on the segment resonates in my head when I look around at the people who don’t believe in flu vaccines or vaccines in general as to how we are supposed to overcome a pandemic when we can’t get compliance against a known killer that’s been around a very long time.

“Shame on us”

“I was already sick I don’t need it”

“Shame on us”

“Hey I don’t believe in vaccines”

“Shame on us”

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