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Combining different layers of vaccinations and personal and public measures to combat COVID-19

By Joanie Koplos

With both of our country’s Pfizer and Moderna Research Labs communicating strong showings in their final phases of vaccine development, there appears to be two strong rays of light at the end of the world’s long quarantined tunnel. According to CNNhealth, Moderna (pharmaceutical company) will become the second company to apply to the FDA (Federal Drug Administration) and its emergency use authorization advisory committee for a coronavirus vaccine’s world usage. Pfizer’s research lab applied on November 20. For your info, the FDA will review Pfizer’s application on December 10. On December 17, the FDA will review Moderna’s application.   

CNN tells us “Starting in July, Moderna gave either its vaccine or a placebo – a shot of saline that does nothing – to some 30,000 people in the United States.”  

Among the approximately 15,000 candidates who actually received the vaccine, only 11 developed the virus. Among the approximately 15,000 people who took the placebo, 185 developed Covid-19. Furthermore, the news media continues “None of the 11 people who received the vaccine became severely ill, but 30 of the 185 who received the placebo became severely ill, and one of them died.” Moderna’s vaccine had similar efficacy rates for the elderly and racial minority groups. CNN does state a startling fact in Moderna’s lab findings: “The company will ask the FDA to review an expanded data set showing the vaccine is 94.1% effective at preventing Covid-19 AND 100% effective at preventing severe cases of the disease.”

“Using 43,538 volunteers, Pfizer’s rates of infection were small for both groups: the placebo: 85 or more cases, and the vaccine treatment: 9 cases or fewer. In Pfizer’s Phase 3 clinical trials, the vaccine proved to be 95% effective, and one study participant who received the vaccine developed a severe case of Covid-19.” More numbers are still to come.

But Nicholas Christakis in his November 14 Wall Street Journal (WSJ) article said: “The Swiss Cheese Model for Combating Covid-19,” cautioning that “Controlling Covid-19 will take a good deal more than a vaccine. Individuals, workplaces and governments will need to (continue) consider(ing) a diverse and sometimes disruptive range of interventions.”  

These should be thought of in terms of layers of defense. Each “Swiss cheese” layer would provide a barrier of some protection. The author continues by saying that this is a classic way of dealing with a hazard that adds a mixture of human, natural, and technological elements. Christakis explains “The presence of holes in any one ‘slice’ of Swiss cheese does not normally cause a bad outcome. Usually, this can happen only when the holes in many layers…line up…bringing hazards into damaging contact with victims.” The ideal situation is for the viral particles to pass through layers of Swiss cheese, while shrinking in numbers as they go through the remaining holes, only to be stopped at the end.   

We all know the INDIVIDUAL OR PERSONAL ACTION of wearing a mask, cleaning our hands, maintaining certain physical distances, and self-isolation. COLLECTIVE INTERVENTIONS are also needed to stem the spread of a lethal virus. These are actions mandated and coordinated by governments. Nicholas cites the following as examples that are not always to everyone’s liking: “Disinfecting public places/often in the presence of plexiglas, closing borders, restricting movements, shutting schools, banning gatherings, closing businesses and exercise facilities, instituting testing and contact tracing, quarantining exposed individuals and issuing stay-at-home orders.”

INDIVIDUAL OR PERSONAL ACTIONS achieve their effect by reducing the spread of the pathogen from person to person. COLLECTIVE INTERVENTIONS deprive the germ of the opportunity to spread.  

Both PERSONAL AND COLLECTIVE INTERVENTIONS work better in combination with one another, as in the combo of:

1. Testing
2. Masking, and
3. A vaccine that is widely available. The WSJ article explains that this latter combo is an example of Swiss cheese slices with fewer or smaller holes. If not aligning when stacked, these measures can work the very best. 

Christakis, concludes with one of his final statements: “In the midst of (some) growing skepticism about vaccines of all kinds, we’ll need to see public education campaigns that reach into every corner of American society.”  

Christakis adds “The good news is that, not too long ago, the U.S. was the world’s beacon (of light) in controlling epidemic diseases. With effective leadership at every level, … , we can work together to build real defenses against Covid-19, layer by layer (of Swiss cheese).” 





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