Saturday, May 16, 2020

Hit me with your best shot

Hit me with your best shot
Come on!
Hit me with your best shot
Fire away

~~ "Hit Me With Your Best Shot" by Pat Benatar

Be Best
No, I'm not kidding. I want your best shot. 

It seems that the Idiot-In-Chief and self-proclaimed genius epidemiologist (he's really good at that stuff, y'all) has decided that we're going to have a vaccine against the Coronavirus that causes COVID-19 by the end of 2020. Amazingly, some scientists are all on board and going along with that timetable, although the vast majority think that is way too optimistic. 

Count me among the latter. 

I never was part of vaccine development but I studied a bit about it and spent my entire career in healthcare. One thing I did do as part of my job was testing new methods against old methods. I.e., when a new test was developed and became available and we thought we might want to switch to it, we ran duplicate tests comparing it to our current test. We needed to make sure it compared well and that the results were shown to be accurate before we adopted the new method. 

Let me tell you...that was involved and tedious enough. With vaccine development, we're talking a whole other level of complexity. Formulating a vaccine itself isn't going to be extremely difficult; it's the subsequent testing that it must endure that takes time and large numbers of tests. The main goals are to find something that is both safe and effective. This does not happen overnight or with the snap of an artificially orange tiny finger. 

That's why I am so dubious of a safe vaccine by year's end. And you know what? If there is a vaccine, and they actually manage to manufacture it in the large doses needed, I will not be getting it immediately, and Ken most certainly will not. You all know how I am about vaccines. They save lives. That is not debatable, although many try. (They are wrong.) I know the truth of it. But I also know the consequences of a rushed vaccine that has not been entirely vetted. Some vaccines have carried the increased risk of Guillain-Barré syndrome (the swine flu vaccine in the '70s) and some, like the first incarnation of the Rotavirus vaccine, resulted in a rare but serious condition called intussusception, which is an intestinal complication that can result in blockage and the need for surgical intervention. (That vaccine was pulled from use and another one was developed.)

To summon an Internet meme, one does not simply walk into a safe vaccine. It requires development, in vitro testing, in vivo testing in animals, and then in vivo testing in humans. The level of antibody development needs to be determined as well as how long those antibodies last, which will determine if it will confer immunity for a matter of years or only of months. Follow-up testing needs to be done to see if any long-term issues arise. 

It might not be rocket science but it's pretty damn complex in a different way. 

Rushing a vaccine to market for mass consumption is a dangerous prospect. I trust nothing that comes from the mouths of political operatives. I trust the science. If the orange idiot starts talking up this vaccine and I don't hear scientists agreeing, I will run the other way from that vaccine. 


Time to make the vaccines
On a related note, I watched the testimony before Congress from Dr. Rick Bright, the whistleblower who said that his warnings about the urgency of this virus went unheeded. (Quote of the Year: "We're in deep shit.") I was dismayed to see many of the Republican congresscritters trying to shield the so-called "president" when it comes to his constant touting of hydroxychloroquine as a therapy, despite no valid scientific studies being done to test its effectiveness against this virus. Most of the studies so far have shown either no efficacy or actual harm, with a worse outcome in many cases. 

But one after another, they sat up there and grilled Dr. Bright about hydroxychloroquine and "why not try it?" I'll sum up Dr. Bright's answer and then I'll give my own to that question. He said, in essence, "Your anecdotal evidence doesn't count for shit." 

My answer is that you don't try treatments when you don't know the outcomes. While the treatment has been around for a long time as a malaria drug and for some other conditions, it has not been fully vetted as a treatment for this virus. There is a shit-ton that we don't know about this virus and about the damage it causes to various tissues and systems, and just shoving a drug at it willy-nilly is irresponsible and negligent at best and downright malpractice at worst. 

Some of these people in Congress keep trying to appease the toddler in the White House and say, "It works for malaria. Why not give it a try?"

The reason I gave on Facebook is basically this: there are many treatments that work for one thing and don't work for another. A simple example is that penicillin-class antibiotics can be quite effective against some Gram-positive organisms like Staph and Strep. (Not so much Staph anymore, but that's because it developed resistance, so much so that penicillin is no longer an effective antibiotic against Staph.) However, due to its mechanism against organisms (it involves differences in cell walls), penicillin and most other antibiotics in that class are completely ineffective against Gram-negative organisms like E coli or Pseudomonas. 

So, to give a treatment example: if you had a patient who presented with septicemia (a blood infection) caused by E coli and you gave your patient penicillin, you would be causing harm because that is an ineffective treatment. Your patient would die because that is a very serious infection, one of the most life-threatening you can get. "What do you have to lose?" Well, when you push ineffective treatments, your patient could lose their life. 

Here's another very simple example: a couple of ibuprofen works great on a headache, but it ain't gonna do shit for your yeast infection, honey. But if you take enough ibuprofen, you risk renal damage. But hey, what have you got to lose, right? 

That's why it is important to conduct the studies and determine whether or not the treatment can cure, mitigate or decrease the length of illness, or if it causes actual harm. We have not done those studies on the magnitude that is necessary and it is beyond irresponsible for people to be pushing any sort of treatment without the necessary vetting. 

I know this was way too science-y but everything I'm hearing from the non-scientists in this administration is grating on my last nerve. It is glaringly obvious that they have no clue what they're talking about. 

Although I have a suggestion. Perhaps some sort of bleach injection or ingestion could help. Come on, fellas.

What have you got to lose?