The recent developments of multiple vaccines for SARS-CoV-2, the virus that causes COVID-19, is exceptionally good news. The Pfizer/BioNTech and Moderna vaccine candidates are based on mRNA technologies. These vaccines use a messanger RNA that codes for the cells in your body to synthesize pieces of the SARS-CoV-2 proteins. Johnson & Johnson and AstraZeneca are proceeding with viral vector vaccines. These vaccines use an inactivated virus that expresses SARS-CoV-2 proteins on the surface of the virus. Novavax and Sanofi with GSK are using a recombinant protein vaccine approach, which uses the actual proteins from SARS-CoV-2 (usually the spike protein). Regardless of the vaccine approach, all of these vaccines introduce proteins from the SARS-CoV-2 virus into your body to be recognized by your immune system. After vaccination, your immune system will be primed to recognize and rapidly eliminate the real virus. The initial studies indicate 90%+ effectiveness for the Pfizer/BioNTech and Moderna vaccine candidates. The AstraZeneca vaccine candidate study has been beset by methodological problems with how the study was conducted. However, the reported 70% effectiveness would provide effective protection against the virus sufficient to control the pandemic. Importantly, the Pfizer/BioNTech and Moderna vaccines require storage and transport at -80 degrees Celsius. The AstraZeneca (and potentially the Johnson & Johnson vaccine candidate) can be stored and transported at standard freezer conditions.

While antibiotics are not effective against viruses, there are antiviral drugs like Reverse Transcriptase and Protease inhibitors for HIV or Tamiflu for Influenza A and B. Unfortunately, viruses have very different life cycles and use very different proteins to take over the host cell metabolism and replicate themselves. Because of these differences, antiviral drugs effective against one type of virus are ulikely to be effective against other types of viruses. It is very important to have antiviral drugs that target proteins important for the specific virus causing the infection. This problem is not limited to viruses. Many pathogenic bacteria have become resistant to available antibiotics. The development of new antiviral drugs and antibiotics is a critical objective for future biomedical research.

This subject has been studied extensively and the data are clear. Disposable masks are effective at blocking the small droplets expelled by people coughing or sneezing. Importantly, masks are most effective at blocking these aerosol droplets for the person wearing the mask. Wearing your mask will protect the people around you. Likewise, the people around you wearing their masks will protect you. As a precaution against Coronavirus (and many other viruses or bacterial infections), a routine disposable mask will protect people around you from your coughing or sneezing IF THE MASK IS THE APPROPRIATE TYPE AND FITTED PROPERLY. In addition to masks, the most effective protection is to avoid people coughing or sneezing, especially in enclosed environments like public transportation and office spaces. The more effective N95 masks provide more effective protection against these droplets, but are best utilized by health workers caring for patients exhibiting infections from unknown biological agents.

Infectious agents including viruses and bacteria do NOT care about your personal liberties. The primary mode of transmission of any infectious agent is exposure to infected people. Mask mandates, quarantines, lockdowns, shelter-in-place, and social distancing are highly effective epidemiological methods that limit your exposure to people that knowingly or unknowingly harbor viral or bacterial infections. These infection control measures ARE NOT focused on limiting your personal liberties. These infection control measures ARE focused on reducing the number of people becoming infected and requiring medical interventions. Advanced medical interventions including ICU and ventilators save lives, but too many patients can overwhelm limited available medical space and resources. Surprisingly, the larger protest gatherings against the lockdowns that have been televised from Michigan, Ohio, Kentucky, and other states over the Summer did not appear to produce large-scale COVID-19 transmission. Neither did the protests over the death of George Floyd and others across major cities in virtually every state. In retrospect, these protests were outdoors and not confined to indoor venues. In contrast, large-scale social gatherings confined to indoor venues and without mandatory masks and social distancing have resulted in increased transmission of SARS-CoV-2 virus.

My initial focus in creating this InfoPage was on direct visualization of COVID-19 infection data. During the course of this outbreak and after communication with scientific and non-scientific members of communities that have contacted, me, my focus has shifted to represent these data in a more rigorous manner. Therefore, the COVID-19 Cases are corrected for population to enable direct comparison of counties across the United States. The Finding HotZones Section now calculates the daily change in number of infections as a percentage from the previous day. This enables more effective comparison of infection trajectories across counties exhibiting wildly-differing populations. The COVID-19 Lethality Section was suggested from several communications to provide a direct approach for readers to consider how lethality is measured.

Since 6/28/20, COVID-19 has become a major "out of control" worlwide catastrophe. Focusing on the United States, the COVID-19 InfoPage has taken the US perspective. The COVID-19 Cases per 100,000 Population has normalized the infection data to population, allowing for direct comparison between counties of different populations. I have had to adjust the scale of this mapping because the number of infections per 100,000 population has become almost astronomically higher across the Midwest. The COVID-19 Deaths by Date remains a simple measure of number of deaths in each county reported in the data. I have taken a different approach to the question of Hotzones. Instead of a bar-graph, I have mapped the Daily Percent Change in COVID Infections on the county map of the US. This provides not only a measurement of the percent change in infections, but a geographical representation of these data. You can interrogate this by looking at the Finding HotZones map, enlarging on counties of interest, and hovering over them with your mouse. You can also select the State, County, and Outbreak Date on the map. Replacing the bar-graph, I have added a County Map of COVID Lethality through 11/25/2020, the last date reported in my dataset. This map provides a geographical representation of counties based on their estimated lethality as calculated by #COVID-19 Deaths/#COVID-19 Infections. These ideas are also observed in the Estimated County COVID Lethality and Estimated State COVID Lethality graphs. These data indicate a new idea for defining Hotzones in relation to increased lethality of infections during the pandemic. In the future, I will incorporate pandemic dates to define time-resolved changes in lethality. IMPORTANT! Evaluating the current outbreak requires us to understand the difference between the initial outbreak and the mature outbreak we are now confronting. Let me present an example. In the initial days of COVID-19 outbreak, 200 new infections would be a 10% increase when only 2,000 infections were reported on the previous day. In a mature outbreak (what we are currently confronted with), we have 2,000,000 infections reported. A 10% daily change based on these number of infections would be 200,000 additional infections over the previous day! A 1% daily change would be an increase by 20,000 infections, or 10 times the number observed in the early outbreak. It is of critical importance that evaluation of current trends in this outbreak are based on proper understanding of the data.

Contact me and propose your questions for the FAQ!