[uupretirees] Re: "Netscape Nurses" newsletter: Breakthrough infections
- From: Eric Russell <ericprussell@xxxxxxxxxxx>
- To: Peter A Poccia <danangdoc@xxxxxxxxx>, Uupretirees <uupretirees@xxxxxxxxxxxxx>, "uupad@xxxxxxxxxxxxx" <uupad@xxxxxxxxxxxxx>
- Date: Sun, 26 Sep 2021 17:23:30 +0000
Thanks, Pietro. Hillary and I got our boosters Friday. The reaction was much
stronger than with the first two shots. My arm is still sore and warm at the
injection site. I had about a degree of fever, loss of balance and
disorientation. I suspect that means that the first two shots were effective
and my body was reacting to the invasive materials in the shot. I seem to be
over it already. Exhaustion is a given but is nearly gone. I slept a lot
Friday afternoon and yesterday.
That said, I'd rather have a reaction than a breakthrough case. Eric
________________________________
From: Peter A Poccia <danangdoc@xxxxxxxxx>
Sent: Sunday, September 26, 2021 12:47 PM
To: Peter A Poccia <danangdoc@xxxxxxxxx>
Subject: "Netscape Nurses" newsletter: Breakthrough infections
I'm sending this to everyone because, if you are fully vaccinated, I thought it
very important, short and it's in plain English. This is what you need to
know; it seems to be the latest, factual information available AT THIS TIME.
Unless you sign up to their website, you cannot read their pages so I've done a
cut and paste below.
Pietro
Medscape Nurses
NEWS &
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POINT<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fdecisionpoint.medscape.com%2F&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158373423%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=BIZ7NPC7Sczy1QsJ4sfhJ08oxA%2B%2BLrsRuMSxr6sn7iw%3D&reserved=0>
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Kaiser Health
News<
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I Got a 'Mild' Breakthrough Case. Here's What I Wish I'd Known
Will Stone
September 20, 2021
Editor's note: Find the latest COVID-19 news and guidance in Medscape's
Coronavirus Resource
Center<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.medscape.com%2Fresource%2Fcoronavirus&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158393415%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=Lxg2aADTALDzPX%2BgJDGpQD43PVg9WwEkggzQPQHQrCE%3D&reserved=0>.
The test results that hot day in early August shouldn't have surprised me — all
the symptoms were there. A few days earlier, fatigue had enveloped me like a
weighted blanket. I chalked it up to my weekend of travel. Next, a headache
clamped down on the back of my skull. Then my eyeballs started to ache. And
soon enough, everything tasted like nothing.
As a reporter who's covered the coronavirus since the first confirmed U.S. case
landed in Seattle, where I live, I should have known what was coming, but there
was some part of me that couldn't quite believe it. I had a breakthrough case
of covid-19 — despite my two shots of the Pfizer-BioNTech vaccine, the second
one in April.
I was just one more example of our country's tug and pull between fantasies of
a post-covid summer and the realities of our still-raging pandemic, in which
even the vaccinated can get sick.
Not only was I sick, but I'd exposed my 67-year-old father and extended family
during my first trip back to the East Coast since the start of the pandemic. It
was just the scenario I had tried to avoid for a year and a half.
Where did I get it? Who knows. Like so many Americans, I had loosened up on
wearing masks all the time and physical distancing after getting fully
vaccinated. We had flown across the country, seen friends, stayed at a hotel,
eaten indoors and, yes, even gone to a long-delayed wedding with other
vaccinated people.
I ended up in quarantine at my father's house. Two rapid antigen tests
<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.npr.org%2F2021%2F09%2F04%2F1034281124%2Fmore-people-are-relying-on-covid-19-tests-but-experts-say-theyre-not-foolproof&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158423390%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=25UWjD3rEK2M%2BnbpzcjNS9jpo4Ao%2BVn9gelt4iY5G1I%3D&reserved=0>
(taken a day apart) came back negative (“Rapid antigen” = what you buy in
drug store. For ANY test to be valid, 2 tests must be take 5 days apart or 1
test 5 days after being infected), but I could tell I was starting to feel
sick. After my second negative test, the nurse leveled with me. "Don't hang
your hat on this," she said of the results. Sure enough, a few days later the
results of a PCR test for the coronavirus (this one sent to a lab) confirmed
what had become obvious by then.
It was a miserable five days. My legs and arms ached, my fever crept up to 103
and every few hours of sleep would leave my sheets drenched in sweat. I'd drop
into bed exhausted after a quick trip to the kitchen. To sum it up, I'd put my
breakthrough case of covid right up there with my worst bouts of flu. Even
after my fever broke, I spent the next few weeks feeling low.
Of course, I am very lucky. I didn't go up against the virus with a naive
immune system, like millions of Americans did before vaccines were widely
available. And, in much of the world, vaccines are still a distant promise.
"You probably would have gotten much sicker if you had not been vaccinated,"
Dr. Francesca
Torriani<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fproviders.ucsd.edu%2Fdetails%2F11556%2Finfectious-diseases-hiv%2Faids&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158423390%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=jBCAAGwPpWHBUvz5M0xPvB4890omCDgiIVR%2FwN4Jdtg%3D&reserved=0>,
an infectious-disease physician at the University of California-San Diego,
explained to me recently.
As I shuffled around my room checking my fever, it was also reassuring to know
that my chances of ending up in the hospital were slim, even with the delta
variant. And now, about a month later, I've made a full recovery.
The reality is breakthrough cases are becoming more common. Here's what I wish
I'd known when those first symptoms laid me low.
1. Is it time for a reality check about what the vaccines can — and can't do?
The vaccines aren't a force field that wards off all things covid. They were
given the green light because they greatly lower your chance of getting
seriously ill or dying.
But it was easy for me — and I'm not the only one — to grab onto the idea that,
after so many months of trying not to get covid, the vaccine was, more or less,
the finish line. And that made getting sick from the virus unnerving.
After all, there were reassuring findings earlier this
year<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F70%2Fwr%2Fmm7013e3.htm&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158433382%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=nq%2FXyXNynhQHnO9P4NpVoEycj1ky1vEyVzd%2FCpgW2k4%3D&reserved=0>
that the vaccine was remarkably good at stopping any infection, even mild ones.
"There was so much initial euphoria about how well these vaccines work," said
Dr. Jeff
Duchin<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fkingcounty.gov%2Fdepts%2Fhealth%2Fabout-us%2Fhealth-officer.aspx&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158443380%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=sscm8GzXYHqwPe8ggtps6qrOBNNFABnhQ7KoZicZbCs%3D&reserved=0>,
an infectious-disease physician and the public health officer for Seattle and
King County. "I think we — in the public health community, in the medical
community — facilitated the impression that these vaccines are bulletproof."
It's hard to keep adjusting your risk calculations. So if you'd hoped to avoid
getting sick at all, even slightly, it may be time for a "reset," Duchin said.
This isn't to be alarmist but a reminder to clear away expectations that covid
is out of your life, and stay vigilant about commonsense precautions.
2. How high are my chances of getting a breakthrough case these days?
It used to be quite rare, but the rise of delta has changed the odds.
"It's a totally different ballgame with this delta phase," said Dr. Eric
Topol<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.scripps.edu%2Ffaculty%2Ftopol%2F&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158443380%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=A9KSJojoZwYa2z%2BinO5cn01UXKNKrDoMyb9d5CtkaD0%3D&reserved=0>,
a professor of molecular medicine and director of the Scripps Research
Translational Institute in San Diego. "I think the chance of having a
symptomatic infection has gone up substantially."
But "quantifying that in the U.S. is very challenging" because our "data is so
shoddy," he said.
The vaccinated still have a considerably lower chance of getting infected than
those who aren't protected that way. Los Angeles County collected data over the
summer as the delta variant started to surge: Unvaccinated people were five
times more likely to test
positive<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F70%2Fwr%2Fmm7034e5.htm&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158453374%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=icPUY7QUWffdvNlVAw%2Fo2fOHF01Xpfs%2BQUEm68rf9SQ%3D&reserved=0>
than those who were vaccinated.
3. How careful do I need to be if I want to avoid a breakthrough?
Looking back, I wish I'd taken more precautions.
And my advice to friends and family now is: Wear masks, stay away from big
gatherings with unvaccinated people and cut down on travel, at least until
things calm down.
The U.S. is averaging more than 150,000 coronavirus
infections<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.nytimes.com%2Finteractive%2F2021%2Fus%2Fcovid-cases.html&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158453374%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=nMfWYZVz1bxqw%2BiFya7eR%2FD2hNf%2BVo%2BEuogl4xlu%2BsQ%3D&reserved=0>
a day (about twice what it was when I fell sick), hospitals are overwhelmed,
and the White House has proposed booster shots. Scientists are still making
sense of what's happening with breakthrough cases.
In many parts of the U.S., we're all more likely to run into the virus than we
were in the spring. "Your risk is going to be different if you are in a place
that's very highly vaccinated, with very low level of community spread," said
Dr. Preeti
Malani<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.uofmhealth.org%2Fprofile%2F922%2Fpreeti-n-malani-md&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158463367%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=wvdkK3XYKsxdvKbPWCj9cep0vzW6xV%2Fv2hZAZUf6Ong%3D&reserved=0>,
a specialist in infectious diseases at the University of Michigan. "The piece
that's important is what's happening in your community."
4. What does a "mild" case of covid feel like?
In my case, it was worse than I expected, but in the parlance of public health,
it was "mild," meaning I didn't end up in the hospital or require oxygen.
This mild category is essentially a catchall, said Dr. Robert
Wachter<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fprofiles.ucsf.edu%2Frobert.wachter&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158463367%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=yTm7YLP3LgiQv8%2F2Y9eak5x06yY6QIjfiY5NJTCjIc8%3D&reserved=0>,
who chairs the Department of Medicine at the University of California-San
Francisco. "Mild" can range from "a day of feeling crummy to being completely
laid up in bed for a week, all of your bones hurt and your brain isn't working
well."
There's not great data on the details of these mild breakthrough infections,
but so far it appears that "you do way better than those who are not
vaccinated," said Dr. Sarang
Yoon<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fhealthcare.utah.edu%2Ffad%2Fmddetail.php%3FphysicianID%3Du1074771%26name%3Dsarang-k-yoon&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158473363%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=fnYDAvTUsWXW8SMECxuO7La9AQriszPDlA6WcJmZToc%3D&reserved=0>,
an occupational medicine specialist at the University of Utah who was part of
a nationwide
study<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.nejm.org%2Fdoi%2F10.1056%2FNEJMoa2107058&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158473363%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=gXApSVt8yffEdk02lfrHd3cnGV0WJ0ggq8SInap6Lp4%3D&reserved=0>
by the Centers for Disease Control and Prevention on breakthrough infections.
Yoon's study, published in June with data collected before the delta surge,
found that the presence of fever was cut in half, and the days spent in bed
reduced by 60% among people with breakthrough infections, compared with
unvaccinated people who got sick.
If you're vaccinated, the risk of being hospitalized is 10 times
lower<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F70%2Fwr%2Fmm7037e1.htm&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158483356%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=hj8eDC76EmuJmpLeq5CqmpBOKeZc3Bh%2B%2FyBEnDuHYYU%3D&reserved=0>
than if you weren't vaccinated, according to the latest data from the CDC.
Those who get severely and critically ill with a breakthrough case tend to be
older — in one study done before delta, the median age was
80.5<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fnews.yale.edu%2F2021%2F09%2F07%2Fstudy-examines-severe-breakthrough-cases-covid-19&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158483356%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=pI4Jn%2F0p%2F9hADVyd7MCotLD3hntK2hnohX2tCN3iXtw%3D&reserved=0>
— with underlying medical conditions such as cardiovascular disease.
5. Can I spread it to others, and do I need to isolate?
Unfortunately, you still have covid and need to act like it.
Even though my first two tests were negative, I started wearing a mask at my
house and keeping my distance from my vaccinated family members. I'm glad I
did: No one else got sick.
The delta variant is more than twice as contagious as the original strain of
the virus and can build up quickly in your upper respiratory tract, as was
shown in a cluster of breakthrough infections linked to Provincetown,
Massachusetts<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.npr.org%2Fsections%2Fhealth-shots%2F2021%2F08%2F06%2F1025553638%2Fhow-a-gay-community-helped-the-cdc-spot-a-covid-outbreak-and-learn-more-about-de&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158493351%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=YpGSM70N2nwp4cGFieJ%2BGk5DwA3Ha0zchTJBqqs2VS0%3D&reserved=0>,
over the summer.
"Even in fully vaccinated, asymptomatic individuals, they can have enough virus
to transmit it," said Dr. Robert Darnell, a physician-scientist at The
Rockefeller University.
The science isn't settled about just how likely vaccinated people are to spread
the virus, and it does appear that the amount of virus in the nose
decreases<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41591-021-01316-7&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158633272%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=%2BFx7YPUhemmPl%2BMX5IDTzmTWOvzDwWqnvqZvJid%2F3cM%3D&reserved=0>
faster in people who are vaccinated.
Still, wearing masks and staying isolated from others if you test positive or
have symptoms is absolutely critical, Darnell said.
6. Could I get long covid after a breakthrough infection?
While there's not a lot of data yet, research does show that breakthrough
infections can lead to the kind of persistent symptoms that characterize long
covid<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Flong-term-effects%2Findex.html%3FCDC_AA_refVal%3Dhttps%253A%252F%252Fwww.cdc.gov%252Fcoronavirus%252F2019-ncov%252Flong-term-effects.html&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158633272%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=JVKIA5O753O3jbFidOf3weU8CJLe9Rkgyhs1q8%2Fjh4o%3D&reserved=0>,
including brain fog, fatigue and headaches. "Hopefully that number is low.
Hopefully it doesn't last as long and it's not as severe, but it's just too
early to know these things," Topol said.
Recent research from the United Kingdom suggests that vaccinated
people<
https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099(21)00460-6%2Ffulltext&data=04%7C01%7C%7C4528982c18664753f39d08d9810d79d0%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637682717158643276%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=IY4UXGiyQ%2BOWl9xsRYGn%2BpRLTOFKxdC3QgGgw9legTk%3D&reserved=0>
are about 50% less likely to develop long covid than those who are
unvaccinated.
This story is from a reporting partnership that includes NPR and KHN.
--
"Nothing in the world is more dangerous than sincere ignorance and
conscientious stupidity" Dr Martin Luther King, jr
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