The “C” word (COVID), the vaccine, and skepticism
Weirdo holistic-minded hippie chick thinks masks are awesome.
I never thought I’d write about this COVID-19 virus on my blog specifically. I find it a bit boring to write about a topic we are all being inundated with day-after-day. I’d rather write about how we are struggling, exploring, suffering, learning, growing, supporting, breathing — through this pandemic, the financial instabilities, and the perpetual evidence and suffering of racism.
I live in the current epicenter of this pandemic — Southern California. Our ICU beds are currently full across Los Angeles County and one in 80 Angelenos have Covid. My friends who work in the ICUs at the County hospital are inundated, and some hospitals are at 200% capacity with patients lining the hallways. Nurses and support staff are exhausted and running on fumes.
This is the surge we have been worried about since March (or earlier, if you were paying attention to an entire metropolitan city in China shutting down in late January). People gathered for Thanksgiving and we are in the thick of the consequences. Many will likely gather for Christmas. It’s going to be an eventful January. I hope it is uneventful for you.
I just learned of 2 more friends who have COVID, plus their entire families. Out of the 5-6 friends, family members or former coworkers I’ve known about, 2 of them were hospitalized. Thank goodness, they are all alive. Some people who recover from COVID experience numerous symptoms for many months. They are now being called “long haulers.” Even the younger people (in their 30s and 40s) who recover easier than others are experiencing:
chronic fatigue;
pain;
heart arrhythmias;
shortness of breath;
sleep issues;
foggy-brain, and
delayed return of taste and smell.
This virus is no joke.
Simultaneously, we have a vaccine. Healthcare workers are seeing a light at the end of the tunnel as the first round of doses are administered. Countless nurses and doctors are posting photos of themselves getting the vaccine, hoping to increase confidence. They’re happy. They’re grateful. They’re hopeful.
Skepticism
Like any weirdo holistic-minded hippie chick, I have had my share of skepticism about medical interventions, including vaccines. I have plenty of criticisms about the pharmaceutical companies, our for-profit healthcare system, and the medical abuse upon Black and Brown people in this country — for centuries, for decades, and even recently. (Remember those immigrant women at the border receiving hysterectomies without their consent just a few months ago?) Yeah.
But I am also a total geek for science, research and technology. I think it is possible for us to question some intentions and practices of for-profit companies while also recognizing their brilliant scientific achievements, and take them for what they’re worth.
Some examples:
Our cesarean section rate in the U.S. is about 1/3 of births. The World Health Organization states that only 10-15% of births should be by c-section. Infant and mortality rates do not improve with more c-sections. It is a major surgery with risk of complications during and for years after surgery. Every pregnant mama birthing in a hospital has a 32% risk of having surgery. That is crazy.
But THANK GOODNESS for c-sections when they are truly necessary! They can absolutely save lives.
There is tremendous greed and unethical behavior by many large pharmaceutical companies. Purdue pleaded guilty to horribly unethical practices of encouraging opioid use, almost single-handedly causing the opioid epidemic, with hundreds of thousands of dead, including many adolescents. Like any large company (or the government) seeped in capitalism, there is corruption.
But IV opioids such as synthetic opioid Fentanyl are what get people through many surgical procedures, and make initial recovery (first 1-2 hours post surgery) manageable. Thankfully there is an effort to provide multi-medication pain management approaches in order to avoid opioid use — such as combining acetaminophen (Tylenol®) and NSAIDs like Naproxen (Aleve®) or Ibuprofen (Advil®). Some surgeons are even refusing to prescribe opioids for some surgeries.
Might as well use a little humor to try to get the point across that masks work! They are simple barrier methods for keeping your juices to yourself so you are not unknowingly spreading viruses and bacteria to people around you.
Conspiracy theories
Critical thinking about something we are told is a skill. It starts with the question, “Hmmm, is that true?” or “Hmmm, who’s perspective is that?” or “What do they have to gain from what I’m hearing?” Critical thinking and understanding how to research and evaluate information is not taught to the general public. Fear or skepticism is the breeding ground for conspiracy theories, and fear is contagious.
There are many conspiracy theories spreading about COVID — from it being a full-blown hoax, masks being pointless or harmful, to the idea that hospitals or doctors are diagnosing people with covid instead of other respiratory infections like bacterial pneumonia so that the hospitals get more money, making the hospitalization and death rates hugely inflated. First of all, “hospitals” don’t diagnose people, and a doctor doesn’t independently diagnose someone with COVID. A doctor orders a nasal swab to test for COVID if symptoms match (i.e. fever, loss of taste/smell, difficulty breathing, fatigue). A nurse performs the nasal swab, and sends it to the lab downstairs. The lab technician processes the swab, results are processed, and entered into the electronic health record (EHR) for that patient. The nurse knows to keep an eye out for lab results in the EHR or the lab tech will call the nurses unit to report results. The nurse usually informs the doctor of the diagnosis if they haven’t also read it in the EHR, and treatment is then discussed.
Nurses are reporting being spat on, and some patients refusing to believe their COVID diagnosis claiming “fake news” and refusing treatment because they insist it’s a hoax. For those claiming that these cases of COVID are just bacterial pneumonia, and hospitals want more money for the COVID cases — that is just not true. If you’re interested in seeing the clinical manifestations of COVID, UpToDate is a healthcare worker-utilized resource. The most serious manifestation is pneumonia, but it is imperative for physicians to know what is causing the pneumonia so that appropriate treatment can be implemented. Viral versus bacterial is going to require different medications and overall treatment.
I wish more people understood that actual conspiracies require a certain amount of control over information. Conspiracies only are viable if a somewhat small number of people are involved, so that the processes and information can remain streamlined and hidden. It is not realistic to think that millions of doctors, nurses, lab techs, pharmacists, researchers, hospital administrators etc are all part of a conspiracy. What does a nurse, or a lab tech making $20/hour have to gain from pretending someone has COVID? We’d all have to be in on it, and we’d all have to be lying to our patients, families, journalists, and neighbors. It’s just NOT A THING.
It’s as misguided as the theory that if you choose to be an organ donor, doctors won’t try to save your life because they want your organs. That is ludicrous, and assumes that one potentially malicious doctor is in charge of a person’s care. There is an entire network of people caring for each patient, including numerous nurses who would stand up against unethical behavior if it even got that far. It is just not true.
Let’s talk about this vaccine.
The Pfizer and Moderna vaccines are mRNA vaccines. They do not contain any live virus or inactivated versions of the virus, like vaccines for other illnesses. The vaccine sends the code for the “spike” protein that COVID is known for (via the “messenger” RNA) so our cells make a copy of the protein spike. When the spike is created, our immune systems recognize it as foreign and start to build up antibodies to it. It does not alter our DNA, and the mRNA and the spike proteins are excreted within a few weeks.
There are no preservatives or adjuvants (the ingredients that usually make vaccines strong enough to be effective) like thimerosal, aluminum or formaldehyde, which have been concerning for many consumers about other vaccines. The lack of preservatives mean the Pfizer vaccine has to be kept very cold (-70° Celsius) during shipping and storage until ready for use. A great explanation of mRNA vaccines and the list of ingredients are here on MIT’s site. If you want an easier and hilarious explanation about how mRNA vaccines work (including “asshole proteins,”) check out this physician on Twitter @WheatNOil.
What are the side effects? Can the vaccine cause COVID?
These mRNA vaccines cannot cause COVID because they do not contain live or inactivated versions of the virus. The reactions that people are having to the vaccine are expected. Based on the clinical trials of 43,000 people plus the current recipients since the roll-out, possible and likely reactions include a sore arm, fever, fatigue/lethargy, muscle aches, and headaches. This does not mean you are sick. It means your immune system has recognized a foreign invader and is doing what it’s supposed to do! Building immunity to an invader is tiring work. Most reactions resolve in the first day or two. Any severe allergic reactions occur within the first 15-30 minutes, which is why there is a mandatory observation period of up to 30 minutes when you receive the vaccine.
At the time of this writing, there have been a total of 6 anaphylactic (severe allergic) reactions in the U.S., and 2 in the U.K. It is suspected that the ingredient polyethylene glycol (you may know it as Miralax for constipation) might be causing the reactions. If you have a history of severe allergy to vaccines, or to food or medicine, it’s a good idea to check with your physician before getting the vaccine.
Fainting after receiving vaccine
One reaction that has been causing suspicions on social media is that some people faint after receiving the vaccine. That is not a reaction to the vaccine itself. That is a quite common reaction to medical interventions called a vasovagal response or vasovagal syncope. It is a stress/anxiety response, where the huge vagus nerve which runs through every organ of our bodies gets triggered, resulting in a parasympathetic nervous system response. Our blood pressure drops, heart rate slows, we can become nauseated, dizzy, cold/clammy or sweaty, and can faint.
It has happened to me because I am generally very nervous about any kind of medical interventions. It happens to some of my patients when an IV is inserted. Some people have the reaction anytime they see blood. And once it happens to you, you are more prone to it in the future.
Any time I receive a vaccine, or blood draw, or pap smear, I have to tell my nurse that I am prone to vasovagal, so they will give me more time to recover to avoid fainting.
If you start to feel the symptoms I mentioned, it is important to either lie down with your legs up, or recline with legs up. This sends blood from your legs (where the blood goes during a vasovagal response) back up to your brain. Give yourself at least 10-15 minutes before trying to get up again. If you get up and get dizzy, lie back down again.
Again, this has nothing to do with the vaccine itself.
My decision to get the COVID vaccine
Here’s a thing about me. I’ve been holistically-minded for half my life, since age 25, when I became frustrated with the failed medical methods of addressing my chronic infections. I’ve also had fear of hospitals and procedures my whole life — which is probably due to a traumatic hospital experience at age 5. It’s partly why I became a nurse — to be there for people when they are feeling scared and vulnerable.
One of my frustrations with Western medicine is the “one size fits all” approach. I think the medical community relies so heavily on medicine, surgery, and vaccines and falls short on additional ways of addressing one’s health and immunity. I feel they don’t do enough to address the causes of chronic illness (diabetes, autoimmune disorders, asthma, heart disease), including diet, poverty, racism, stress, and a for-profit healthcare system. I wish doctors and public health officials were recommending people eat more plant foods, take vitamins, sleep, rest — as well as take the vaccine. I realize that not everyone has the same access or ability, but it wouldn’t hurt to mention it.
Despite my frustrations, I will be getting this vaccine! Like most healthcare workers who know how horrible this virus is, I am incredibly grateful they are available. And I appreciate that it’s an mRNA vaccine with no preservatives.
But I will definitely tell my nurse who administers my vaccine that I need to lie down afterwards! :)
Please wear your mask over nose and mouth…. please do not gather in groups…. please be patient and let’s get ahead of his awful virus so we can hug our loved ones in 2021.
May your holidays and new year be safe and peaceful.
For additional information on covid-19 and the vaccines, please listen only to public health organizations, prominent medical schools and physicians, and reputable news sources:
California Public Health Department (or your state or county’s public health department)
Accounts to follow on Instagram with reliable info:
@dr.risahoshino. Public health doc who has been sharing tons of helpful info, including myth-busting and a compare/contrast of the Pfizer and Moderna vaccines that includes a ton of helpful info in general.
@doctor.darien. Emergency physician in Southern California, and medical contributor for ABC News. He’s done a lot of live interviews on IG with fellow physicians, including epidemiologists and an OB/GYN (his brother!).
@capublichealth or @lapublichealth - or search for your county’s public health department
@jessicamalatyrivera. Infectious Disease Epidemiologist, also doing live interviews with fellow physicians.
Please remember that any of my writings are for informational and educational purposes only. I do not give medical advice. Please consult with your provider before making any medical decisions.