Another of our friends got their second doses yesterday, and [our son in Texas] is expected to receive his second dose of Novavax in the clinical trial today in Austin. Johnson & Johnson’s vaccine is beginning to be distributed today. And Marin County’s health official said over the weekend that the statewide MyTurn vaccination scheduling website is now working for Marin appointments.
But things still don’t add up. The J & J distribution will be “uneven” for the near future, Newsom and Blue Shield still haven’t gotten their act together and are not answering questions about the number of doses that will be available in the three-week forecast window we are promised. And as counties like LA add teachers to the list of allowed categories it still looks like getting the shots into arms will take six months to a year at current rates. Doing the math: With the addition of teachers, 3.4 million Angelenos are now eligible, or 6.8 M doses needed. 2.1 M doses have been administered so far. That leaves 4.7 M doses are still needed to cover the new pool. Garcetti announced that they had given 90,000 shots last week for LA city (40% of the county), the high-water mark so far. So that works out to 20 weeks to cover just these people, putting us into August for just this group. My guess is that LA County doesn’t have the capacity for its 60% share, and it’s more like 40 weeks at current rates. As usual, we need to triple the current distribution rates to make a dent. It’s been this way since Inauguration Day.
Two small items of note today. California counties still cannot get 3-week predictions (much less promises) of how much vaccine they will be allocated by the state. The distribution process is being transferred to Blue Shield under a contract. The governor says talk to Blue Shield about it, and Blue Shield has no comment. We’re almost in March. The post-Trump distribution problem is still largely broken, and you cannot blame it on winter storms.
And in better news, the FDA announced that long Phase III clinical trials will not be needed for already-approved vaccines that are going to be reformulated to combat new SARS-CoV-2 variants. Instead blind trials involving just hundreds of subjects will be adequate, meaning that “generation 2” vaccines could be available within months of research and development.
After weeks of anxiety and lethargy and cold, often gray weather, this past Wednesday we got the heating system in our house tuned up. Today was a sunny Saturday, still a bit on the cold side, but bright and tinged with green. The daylight hours are now longer (6:30 am to 6 pm) and the sun definitely brighter at midday. Everywhere in the small suburban towns I bicycled past, people were out in the cafés. Entering San Rafael’s 4th Street, the first three groups I cycled past on the sidewalk didn’t even bother to wear masks, and of course those in the beer gardens and café parklets didn’t either. It was dreamlike, you could imagine we weren’t still seeing thousands die every day. But with the weather and the green shoots and the weariness who could blame these people?
Acacia Silver Wattle
Shady Lane in Ross was particularly beautiful with the young Prospector elm trees that replaced the diseased elms all putting out baby leaves. Elsewhere, there were abundant camellias, citrus trees overflowing with oranges and lemons, and magnolias and ornamental fruit trees in bloom.
Lark Theater
I had started painting again the day before, forcing myself back to the canvas, after feeling “why bother?” for six or eight weeks. The exercise was somewhat rewarding, rediscovering the small delights of yellows, oranges, and blue sky pigments. Today was one of my two sons’ birthday. Even though he was out of touch, on a weekend getaway somewhere in deep Oregon, we could imagine he was filled with spring happiness as well. Meanwhile, his older brother was enduring the Texas winter disaster where millions across the state were without water or electricity for days on end in zero-degree weather. His inconvenience in having to boil drinking and cooking water was probably outweighed by the fact that he could share this medieval experience with his girlfriend, the two of them iced in for nearly a week.
So now Rachel and I await our second vaccination dose this coming week, hoping that the supply has not been broken. Across California, they are still trying to open schools. Newsom, who seems less and less confident every day, has ordered that 10% of the doses in the state will be allocated to teachers, but at the current delivery rates, that would take an entire year to give them all shots. The teachers union in LA is holding firm on vaccinations being a prerequisite to a return to the campus. And [two of our closest friends, both in the preferred over-70 demographic] are still probing the broken system trying to procure even a first shot. It is not an impressive response by the fractured health care system we have.
The promise of higher rates of vaccination is always described as “coming soon,” “by March,” or “by summer.” We will wait and see if the world is any better by the September and October dates of planned weddings and a trip to France. The G-7 is ponying up minimal billions for the purchase of vaccines for the Third World, but it appears as though they just want to do public relations against China and Russia, who are offering real doses now at cost, or for free, to many countries (not just future money). No one expects that the rest of the world will be able to cover their populations for two to three more years, by which time we will probably be seeing a radically new variant of SARS-CoV-2, and we’ll need another 10 billion doses of vaccine to handle it. Just ask Larry Brilliant.
Today, January 29, reports from phase 3 trials of the single-shot Johnson & Johnson adenovirus vaccine, and of the two-shot Novavax protein vaccine were published, and both seem effective (both may be more effective than the two-shot AstraZeneca adenovirus vaccine). Nat probably got a dose of the Novavax two days ago.
Last night I watched the UCSF Virtual Grand Rounds, and Shane Crotty, an immunologist at the La Jolla Institute, presented a lot of background information on the potentially dangerous new virus variants in the UK, South Africa, and Brazil. He was guardedly optimistic that the current formulations of most of the vaccines, together with the resiliency of the human immune response (memory B cells, CD4+ T cells, and CD8+ T cells, as well as the wide variety of antibodies that arise from exposures) will still work with fairly good efficiency against these new variants. What stood out to me from his presentation was that the physical binding properties of the spike protein in the virus to the ACE2 and other receptors in the body, are not perfect predictors of which virus variants will prove more transmissible, more infectious, or more deadly. Predictions of which variant will predominate, how fast it will take over, and whether we will see the constant evolutionary emergence of more or less dangerous variants, is still a guessing game.
Crotty published a paper in Science: ‘Beyond sterilizing immunity, immune responses that confine SARS-CoV-2 to the URT and oral cavity would minimize COVID-19 disease severity to that of a ‘common cold’ or asymptomatic disease. This outcome is the primary goal of current COVID-19 vaccine clinical trials.’
A hopeful prediction from Washington DC in the LA Times for January 22: ‘Fauci provided updates on how scientists are tracking mutations of the virus, and said he hopes to see 70% to 85% of Americans vaccinated by summer’s end. If that happens, he said, “I believe that by the time we get to the fall, we will be approaching a degree of normality. It’s not going to be perfectly normal, but one that I think will take a lot of pressure off the American public.”’
Meanwhile in California, they don’t really know how many people have been vaccinated. On the same day: ‘“This vaccine distribution is being jerry-rigged on a famously fragmented health system and underfunded public health infrastructure, which produces inconsistencies county by county and provider by provider but also problems with getting timely data to see how California as a whole is doing,” said Anthony Wright, executive director of Health Access California and a member of the state’s vaccine advisory committee.’
But now it’s January 28, and at least two seniors have gotten the first dose of Moderna vaccine, thanks to the incredible
organization (everything at KP has been online for a decade or more so they can predict the numbers they will need–kind of like a universal health care system would),
planning (setting up cold storage and procuring a large number of doses of vaccine)
efficiency (“mass” vaccination sites at least a dozen locations within a drive from the Bay Area), and
generosity (allowing non-KP members like Rachel and former KP members like me to receive no co-pay vaccinations)
of Kaiser Permanente Northern California. Apparently KP Southern California does not have the same quantity of vaccine and is to date still limiting access to people 75 and older, even though the state announced on January 14 that 65 was the new cutoff age. But we two are happy, once having passed the anxiety of two days of wondering whether it would really happen.
Rachel on Tuesday in San Francisco:
About to be vaccinated in the 2350 Geary tent
Me on Wednesday in Oakland:
Moonlight Sonata in the 380 West MacArthur observation room
We are starting to feel more confident about resuming what were going to be our retired lives, being able to visit our children, travel abroad, museums, dinners, tango, art classes, life.
And this morning, Newsom’s team finally realized how messed up the distribution was in California and cut a deal with Blue Shield (apparently he has some lobbying contacts with them) to run the distribution to counties and hospitals going forward. From the LA Times: ‘The new statewide vaccine distribution network overseen by Blue Shield will comprise a wide variety of locations at which vaccinations will be administered, including pharmacies, community health centers and temporary pop-up locations.’ We will see in a month whether Blue Shield is up to the task–it sounds daunting in a state as big and far-flung as California.
And a final vaccination note, also from the LA Times today. The airline industry (which I have increasingly less empathy for) is asking the WHO to say that passengers with vaccination cards should be able to skip all the quarantining, testing and other requirements for international air travel. Hopefully, WHO will not fall for this pressure without having scientific data indicating that there is a dramatic decline in transmissivity of virus from those who have been vaccinated. Which I hope is the case!
Last week I began French language lessons with the Alliance Française de Santa Rosa. My instructor is a très sympa young woman whose family is from the Charente near Bordeaux. I signed up for level A2, and feel pretty comfortable starting at that level. The words will come back, and I hope the pronunciation will as well. There are two other students in the class who really are A2-ers.
Yesterday was a Sunday, and [my Feldenkrais practitioner] called me at 8 am, waking me out of half sleep. She was alerting us to the availability of COVID-19 vaccine through Kaiser Permanente. I held my silence until 8:45 and then woke Rachel, who took about 30 minutes to realize that getting vaccinated was more important than sleep. The next two hours were spent on the phone with Kaiser, at the end of which we both got appointments for next week, in Oakland for mine, and in San Francisco for Rachel’s. This was all due to the fact that after carefully setting up priority groups 1a, 1b, 1c, and 2 (Rachel and I are in 1c), the CDC and the California director of public health gave up after finding that 65% of vaccine doses were not being administered. And so Newsom opened the shots to all of us over 65 on January 13.
Rachel was so energized by the thought of being released from fear of the virus that she spent the rest of the day spreading the word about the Kaiser vaccinations to a dozen friends, all of whom got appointments within the next three weeks. Only [two friends in Southern California] decided not to run the Kaiser gauntlet, but rather to wait for their doctor to call them when their turn would come.
On Saturday out of boredom we had started thinking about a family Christmas in Hawaii, and found that rooms in Poipu, Kauai were already starting to disappear. So on Sunday, after the vaccine rush, we also started vacation planning for 2021 in a serious manner. Rachel booked a suite of rooms at Kiahuna for the week after Christmas, and I started my usual travel research for our September trip to the East Coast for weddings, and to France for walking with [those SoCal friends]. I am still hoping we can visit Provence and Marseille. There’s a drive between the Dordogne and Provence that goes through the Gorges du Tarn, and a château that we could stay at half-way through the gorge. But we will see; Rachel feels anxious about a long vacation, and we now have the “problem” of an additional two weeks of U.S. travel on this trip, due to a Labor Day wedding of [the daughter of a college classmate] in New York.
Shoes
Another pandemic activity: massive housecleaning. We sent 40 pairs of shoes and countless jackets, dresses and other hardly-worn clothing to the Goodwill box.
As Congress started a dreary day of hearing objections by Republican members to all six of the states that Trump assumed he won, a process that was expected to take 18 hours or more, the Capitol was invaded by Proud Boys, QAnon following realtors, and other fanatics, after Trump urged them on during a morning rally.
Rachel and I were at home and just happened to see it all begin on C-SPAN, when there was a request for “order in the House,” followed by Nancy Pelosi being quietly escorted out of the chamber without any announced reason, and then… chaos. The horrible invasion persisted for four hours of looting and hooting, in which five people succumbed. In the evening, some, but not all of the Republican Senators who supported the objections gave way, and after voting down the Arizona objection, Biden and Harris’ electors were duly certified by a stone faced Mike Pence and a happy bunch of Democrats.
It was perhaps appropriate that the day before, I crashed Rachel’s car into a mega-truck parked on Magnolia Avenue across from Emporio Rulli. I think it was exhaustion, wine, or espresso taken during the agonizing weeks since November 3rd, when we had nothing on the media besides political craziness, and nothing on the COVID-19 front besides skyrocketing case counts stemming from the Thanksgiving and Christmas holidays. New case counts in Marin County went from 9 on October 15 to 172 today. What a dreadful and dire situation.
Now it’s nearly time for Biden to take office, and the vaccine rollout, broken as it is, is actually happening.
The Bipeds' Monitor 