COVID-19 Update 9/16: Numbers, Vaccines, Flu Shots

Dr. Steven Bishop went live on Facebook for another COVID-19 update on Wednesday, September 16. He discussed the latest numbers in Virginia and the United States, the status of vaccine trials and whether the AstraZeneca trial that got halted is something to worry about, and the various types of flu vaccines available. Watch the video below and read on for the full recap. 

Having trouble getting the video to play? Get troubleshooting tips here.)

COVID-19 Numbers

Let's dive straight into the COVID numbers. Looking at Virginia cases, they continue to go on this very slow decline. We are still having new cases every day, of course, but the new cases —we had a couple of peaks in the summer actually, which we didn't really see in real time. The data has been updated after the fact. And so now we're seeing the cases and actually the case numbers throughout most of the summer were similar to the way they were in May after the revisions have been completed. That being said again, like we've talked about, most of these cases are asymptomatic or minimally symptomatic people.

And if you look at the fatalities and the hospitalizations, they still have stayed extremely low. Hospitalizations in Virginia have been reported in the low double digits or the single digits for quite some time now, definitely the last couple of weeks. Currently, as of yesterday, there were five hospitalizations, new ones reported in Virginia. And if you look at deaths or fatalities, again in Virginia at least, the numbers continue to stay in the single digits for the large majority of the days, a few double digit days here and there. But for the most part, definitely under 10 per day, which is good. And our testing percent positivity is staying stable, right at just under seven, 6.9% today or right around seven for the last few weeks. So I think that's all good news and good information.

And I think this is why you're starting to see a lot of school systems start to reconsider bringing people, at least some students, back into the classrooms. I know Chesterfield last night or Monday night, excuse me, decided to do that for some of their special education children.

And I think other counties will probably follow suit assuming that the data remains stable. Now, if you look nationally at the CDC data, there continues to be lots of new cases every day and that is not changing really now. We definitely are down from our peak back in the summer where we peaked out at around 75,000 cases a day nationwide. We are looking at about 35,000 cases a day at this point. The seven day moving average is about 35,000 cases. So definitely down around 50% from our peak.

Definitely not as low as we would like, and unfortunately we're still seeing, around a thousand people around the country dying each day from the virus, or, a thousand people dying with or from the virus.

Again, it's kinda tough to tell and we won't really be able to tell for some time, but around a thousand people a day in the country are dying who have tested positive for coronavirus. Now, again, whether they're dying directly out of the virus or with the virus and from something else, that's going to take some time for our epidemiologists to sort out, but regardless it's still too many. And obviously we still have things we need to do, and hopefully we will continue to see progress on a number of fronts.

Vaccine Updates

Treatment trials are still ongoing. Vaccine trials are ongoing and I'll go ahead and take a brief divergence and talk about the AstraZeneca trial that is going on that has been suspended in a number of places. I think we talked about this briefly previously, but I just want to mention it again.

The vaccine trial in the United Kingdom was halted and halted in most other places around the world. This is one of many vaccine candidates and the UK has resumed, I believe, the vaccine trial at this point. It seems that the individual who had an adverse reaction in the trial, and again, it's not clear whether it was a person in the treatment arm or the placebo arm who had the reaction, they had something called transverse myelitis, which is an inflammation of the spinal cord.

Now that could have been caused by the vaccine. It could have been caused by COVID. It could have been caused by any number of other things. Transverse myelitis is a clinical phenomenon that happens all the time. I've seen it many times. Many of my neurology friends will tell you they've seen it many, many, many times throughout their careers.

It's not an unheard of inflammatory disease of the spinal cord, so it's not something that's necessarily unique to COVID, unique to this vaccine trial, or anything else. I wouldn't be overly alarmed about this, and I think the data safety monitoring board for the vaccine trial in this case seems to be doing their job pretty well. And they have resumed the trial in the UK. I think the US still has not resumed their trials and some other countries as well, but I suspect they will do so soon.

So that's good news. More data to come as always with these things. It's going to take some months before we really have good information and really know if these vaccines are going to be both safe and effective.

Flu Shots

So it's that time of year. Anytime between now and mid-October is really the ideal time to get your flu vaccine. That way it has time for the antibodies to kick in before flu season really gets underway. We have not seen any flu activity in Virginia as of yet, but I suspect we're only a few weeks away at this point. So go ahead and get your flu shot now if you haven't done that.

I want to talk a little about the major types of flu vaccine. So there's sort of the standard flu vaccine that's called the quad — it protects against four different influenza viruses, a couple of A type and a couple of B type viruses. And this is the one that most people should get. Most adults should get and kids tot.  Sort of a quadrivalent vaccine. That's the standard one for all of you guys, 18 and up, for sure, definitely get this one.

For some of our older patients in the 50 and up crowd and definitely in the 65 and up crowd, you actually want to get a higher dose vaccine, because it works better for creating the appropriate antibody levels to protect you against the flu. The most common one for this actually goes by the name FluZone. That's the one you want if, especially if you're 65 and up, but perhaps if you're in the 50 up crowd as well. It gives you a little bit more protection.

And then same thing, if you have an egg allergy or you want to take a higher-dose flu vaccine to give yourself a stronger antibody response then FluBlock is the one to take, if you have an egg allergy or you want a higher dose vaccine for some other reason.

Any of those vaccines is fine for adults. We definitely recommend the FluZone for people 65 and up, and for 50 and up, you can get any of them and that is perfectly fine. People with egg allergies definitely get the FluBlock vaccine.

Like I said, now's the time get the flu vaccine. We are starting to give those out at our practices here at PartnerMD, but you can get them pretty much in any local pharmacy. I know Target, Publix, CVS, they're all giving away gift cards and various incentives for coming in and getting your flu shot. So you might as well go ahead and get it, protect you from the flu, and get a gift card. Why not? Right.

Your Questions, Answered.

• I had a severe reaction from the high-dose flu vaccine several years ago. I also had the pneumonia shot at the same appointment. I am 73. Should I take the high dose this time? I have high fever and total out of it and lethargic for 4 days. No egg issue. Maybe allergic to what drug is suspended in? 
  
  Yes, all vaccines can cause reactions. That's definitely true of flu vaccine and pneumonia vaccine as well. It's hard to figure out which one might have been the culprit if you got two at the same time. The flu vaccine normally will cause some kind of sore arm and maybe even low grade fever, kind of feeling yucky for a couple of days, but unless you're allergic to a component in the vaccine, the reaction shouldn't be too bad. If you do have a reaction like that or an egg allergy, you might want to just use the regular dose vaccine or use FluBlock instead if it's an egg allergy issue.
  
  And then I would definitely recommend, if you're someone who's sensitive to vaccines or medicines, just get one vaccine at a time. That way you don't overload your system there and give yourself too many things to respond to.
  
  The important thing to remember about flu vaccine that a lot of people do worry about is that the flu vaccine may give them the flu. It can sometimes make people feel like they had the flu for a couple of days, because that's kind of the idea, right? You want to trick your immune system into thinking that you've been infected with the flu, so that it'll produce antibodies and an immune response to the virus particles in the vaccine. But without you actually having to be sick with the flu, so sometimes people can feel pretty yucky for a few days.
  
  The high-dose ones can do that as well as the regular dose ones. But there's no live virus, in the vaccines. It's either inactivated virus or just viral particles, and they cannot actually make you sick with the flu as far as an actual infection.
  
  Now, when the nasal spray vaccines were out, you could actually get active influenza from the nasal spray vaccines, because those were what's called an attenuated virus vaccine, meaning that the virus was there. It was just in a weekend form. But those are not currently really being used or on the market for a whole host of reasons.
  
  But all the flu shots... they cannot actually give you flu infection, but certainly can give you reactions, that is for sure."
• Do you see any shortage of PPE coming up?
  
  I'm hoping not. The only one that still seems to be an issue is N95 masks. We've been able to pretty much get everything else we need, but N95 masks are still at a premium. I suspect we'll continue to have shortages and that the manufacturing plants just still have not caught up with our need for N95 masks, but other masks, surgical masks, gowns, gloves, all those sorts of things seem to be in good supply at this point.
  
  And hopefully it will stay that way through the flu season and through the following winter. So good things there. Definitely still an issue with N95s, but overall PPE supplies seem to be no problem. Same thing with face shields. Those are easy to come by at this point and all that's good, especially as school systems start considering going back to classes, I know they're going to need to use more PPE for various reasons, not the least of which is if people do get sick at school, they will probably need to be isolated. So donate PPE for those sorts of things.