PLUMMET

 So....here we are.

A space of relative stability mixed with a lot of hope. Our numbers in Ontario were under 2500 again today with a 7 day rolling average that continues to decline. Fifty-six percent of the population of Ontario have received their first dose, that's a 4 % increase in 3 days. Our rate of vaccination has increased dramatically and will continue to do so with the supply of Pfizer and Moderna vaccines ramping up. The R value was .89 on May 13th. It is .86 today. Very nice. The lower we go below one, the less community transmission of COVID-19. The number of patients hospitalized, in ICU and on ventilators continues to decline. We are preserving the capacity of our healthcare system. I harp on this graph but it gives me hope. https://covid-19canada.com/graphs Scroll down to the Ontario graph titled 'New Cases Analysis by Date Clickable & Scrollable Graph As of 5/16/2021, 12:52 PM (PST) New Cases: 2,199 New cases and the 7 day rolling average both declining. Here is what I have learned about the Pfizer vaccine. The antibody response to this vaccine is 3 and 1/2 times larger in older people when a second dose is delayed to 12 weeks after the first. Source: https://www.cbc.ca/news/health/covid-19-pfizer-second-dose-delay-more-antibodies-study-1.6026765 That's good news. Canada made the right decision in our era of vaccine scarcity, to delay the second shot. I'd like to put this to rest at this point. People who expected to get their second dose sometime in July are now being called in 4 weeks earlier for their second dose. That is why the date of the second vaccine was often not given after the first dose. There was an expectation that we would be able to shorten the interval between vaccines once our supply of vaccines ramped up. Here is what I have learned about the AstraZeneca vaccine: A very, very small group of people have an immune system that responds to this vaccine by producing antibodies that go after their own platelets. Platelets are tiny blood cells that help your body form clots to stop bleeding. They stick together in clumps at the site of an injury or damage and form a plug or clot that stops the bleeding and begins the process of healing damaged tissue. If your own antibodies attack these platelets, the whole clotting process gets messed up causing either clotting or bleeding where we would not normally see it. In the case of the AstraZeneca vaccine, the clots that are formed in this cascade of events are called VITT ( vaccine-induced thrombotic thrombocytopenia ). The rate of these clots after the first dose is about 1 in 60,0000 to 1 in 100,000. Rare. But enough for the powers that be to press pause and only because at this point, we have other vaccine options. If AZ was the only vaccine we had, this rare risk would be an acceptable risk in light of a virus that is now extremely dangerous and deadly with variants of concern tripling the rate of serious illness, hospitalization and death. Please stay safe until 75% of us are vaccinated. But the thing is, people who get this rare clot after the first dose, do not get the second dose of the AstraZeneca vaccine. In a study of millions of people in the UK, the risk of getting this clot after the second dose appears to be 1 in a million. The unfortunate folks with that quirk in their immune systems that led to VITT after exposure to the vaccine are no longer in this group of people who get the second vaccine. Take home message: Your risk of getting VITT after the second dose is very, very rare. Turning to Mix and Match studies, also out of the UK, there is good evidence that having an AZ vaccine first and a Pfizer vaccine second is safe and effective.....BUT, this study is small, only 800 or so participants. When you are looking for rare events like a 1 in 60,000 clot, you need to follow more study participants than that. That 800 may be a group that is not a risk and was not destined for VITT after exposure to the vaccine. To search for very, very rare events, you require millions of study participants. So, in the coming weeks, the smart people - scientists, medical experts and epidemiologists will determine whether or not the 2 million Canadians who had a first dose of the AZ vaccine and are waiting to find out what their second dose will be? It looks like either option, a second dose of AZ or a second dose of Pfizer will be safe and effective. I trust these folks. Let's wait and see. Extending the dose between these vaccines improves the immunity we develop. We have time. In the meantime, one dose of any of these vaccine protects us significantly. That one dose combined with our public health restrictions ( which will be reset and loosened in June as a result of rapid mass vaccinations, have not doubt) will keep us safe. Watch these posts over the next to weeks as we hit 60 % first dose vaccination rates. I will use the word, 'PLUMMET' many times over and with great glee. Proof: U.S. CDC says nearly 45% of adults in the USA are fully vaccinated, 58% have had 1 dose. COVID-19 deaths in the United States have tumbled to an average of around 600 per day, the lowest level in 10 months, with the number of lives lost dropping to single digits in well over half the states and hitting zero on some days. Restrictions have loosened in many states. In some states, restrictions no longer exist. I don't think that's a good idea until we have reached herd immunity. The variants may have a hay day if more than 40 % of the population are still at risk for COVID-19.....sitting ducks. Hang on tight and don't change a thing for the next three weeks people. Again, we have got this. Grateful that we live in a country, one of only a handful that is now in this privileged position, to have these vaccines and these intact health care systems. I will remind you of that when I come asking for help to get the folks in Lesotho vaccinated too. Anne-Marie Please share For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here: https://www.braceletofhope.ca/ways-to-In