November 16, 2020
COVID-19 Quick Takes—Part One
By Michael D. Shaw
1. Masks—A study—originally published on October 23—touting the efficacy of masks has been withdrawn. In the original findings, hospitalizations for COVID-19 decreased in 1,083 US counties after lawmakers passed mask mandates. “The authors have withdrawn this manuscript because there are increased rates of SARS-CoV-2 cases in the areas that we originally analyzed in this study.”
As it is, with infections and hospitalizations on the upswing in the US, despite near universal mask-wearing, many are starting to wonder about such policies. According to Sweden’s top infectious disease expert Anders Tegnell, “We are worried that it [mask mandates] would diminish social distancing, which is definitely the most important part. The studies so far have not shown a dramatic effect, countries such as France and others, which have obligatory mask-wearing in place, have still experienced a big spread of the disease.”
And then there is the matter of cloth versus paper masks. Everyone has seen those blue and white paper masks. Yet, virtually all official guidance speaks of washable cloth masks preferably, even if paper masks are included in the same discussion. It seems that the “gaiter” style face coverings get lower marks.
2. The Pfizer/BioNTech Vaccine—We’ve been hearing a lot about this novel vaccine for a novel coronavirus. But, welcome to a classical “good news/bad news” situation. Surely, it is an elegant idea to base the vaccine on messenger RNA (mRNA). The usual vaccine methodology employs either living but weakened microbes, dead microbes, or pieces of microbes (such as proteins). This brute force approach is cumbersome since the virus in question must be cultured in a cell.
mRNA can be synthesized outside the cell, and a vaccine dose can be prepared. The mRNA enters your bloodstream, and causes your own cells to create the foreign nasty protein, typical of SARS-CoV-2, that will then elicit a vigorous immune response. Since a targeted response is based on a specific protein being created, mRNA vaccines should, in theory, be safer than conventional vaccines. However, unlike its close relative DNA, RNA is notoriously unstable, and this vaccine must be stored at extremely low temperatures: minus 70 degrees Celsius (-94 F) or below.
“The cold chain is going to be one of the most challenging aspects of delivery of this vaccination,” said Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security. “This will be a challenge in all settings because hospitals even in big cities do not have storage facilities for a vaccine at that ultra-low temperature.” And, uh, cold comfort that no less than the Mayo Clinic sees this as a big problem.
“We’re talking about a vaccine that needs storage at minus 70 or 80. That’s a tremendous logistical issue not only in the U.S. but outside the Western world,” said Dr. Gregory Poland, a virologist and vaccine researcher with the Mayo Clinic. “We’re a major medical center and we don’t have storage capacity like this. That will be true for everybody. This is a logistical obstacle.”
Moderna’s candidate vaccine uses a similar technology, but does not require such low temperatures. For a deep dive into the technology of mRNA vaccines, consult this article.
3. The Vitamin D Connection—Researchers in a Belgian hospital have found a “clear” link between vitamin D deficiency and serious cases of COVID-19.
The confirming study will be published in the American Journal of Clinical Pathology on November 20. The authors show that nearly half of the 16,274 COVID patients considered were vitamin D deficient—especially the male subjects. The idea of vitamin D supplementation for protection against the ravages of COVID-19 had been advanced earlier.
4. Could Melatonin Be A Therapy For COVID-19?-—Results from a study done at the Cleveland Clinic indicate that OTC sleep-aid melatonin could become a treatment option for this disease. These results were obtained using an artificial intelligence program developed by the Clinic’s Lerner Research Institute. The AI was being used to identify drugs that might be repurposed for COVID-19 therapy.
Analysis of patient data from Cleveland Clinic’s COVID-19 registry revealed that melatonin usage was associated with a nearly 30 percent reduced likelihood of testing positive for SARS-CoV-2 after adjusting for age, race, smoking history, and various disease comorbidities.
Stay tuned for more quick hitters.