Vaccine 'error' report was misleading: My letter-to-the-editor

There were many reports over 2 or 3 days last week in the Observer-Reporter (a newspaper in Washington, PA) about the misuse of Moderna vaccine, namely using the vaccine intended as second dose for the first dose.  We read the headlines of  “Error costs 200K doses” and “DOH talks vaccine error”.  It also said the second doses were “accidentally” or “inadvertently” used as the first doses, even blaming “First, second Modern doses in identical packaging”, as seen in the headline.  It led Washington Health System CEO to announce in the newspaper, saying they were not impacted as they use Pfizer vaccine.  The PA health officials even said they knew which vaccine centers “made a mistake”, but preferred not to make public.

I am befuddled. The first dose and the second dose are identical for either Moderna or Pfizer vaccine.  How can it be a mistake or cost anything using the same vaccine as the first or second dose.  This is what prompted me to write the letter-to-the-editor, in which I state the pro and con of the two different strategies: One is to give out vaccines received as soon as possible, the other is to reserve for the scheduled second doses before taking appointments for the first doses.  This is not a right or wrong approach.  Which option to pursue depends on the vaccine supply status.

We are racing for the vaccinations of the whole population against the emergence and spread of new variants.  Having a sense of urgency we need to stride for the most efficient vaccine use.

Wearing face coverings may reduce the severity of Covid-19 if the full protection fails

It is unfortunate or even sad that wearing face covering has been politicized, thus reducing the effectiveness of public health policy implementation. I never got tired of saying something exhorting general public to wear face covering whenever the occasions call for it. I wrote a letter-to-the-editor to the Observer-Reporter (a newspaper at Washington, PA) to this effect in early April. I had another letter published today (Sept. 22) advocating a new concept that has been supported by many evidences observed. I wrote an article of “The scientific basis of wearing face mask” in my blog, although article like this is inherently dull and dry.

I basically want people to be aware that wearing face covering may not fully protect one from getting COVID-19, but it may potentially decrease the severity of the disease as wearing face covering may reduce the amount of viruses one receives. This is consistent with a well-established theory of viral pathogenesis, which says that the severity of the disease is proportionate to the viral inoculum received. An article in the July 14 Proceedings of the National Academy of Sciences reveals that “higher doses of administered virus led to more severe manifestations of Covid-19 in a Syrian hamster model of SARS-CoV-2 infection.”

The rate of asymptomatic infection with SARS-CoV-2 infections was estimated to be up to 40% according to a CDC report in mid-July, whereas the rate of asymptomatic infection was more than 80% in the setting of universal facial masking.

I threw in another info that taking vaccine may potentially reduce the severity of the disease when the full protection fails. The targeted readers would be those who refuse to take vaccine for whatever reasons.

My letter-to-the-editor exhorting everyone to wear face coverings in public

I have a letter-to-the-editor published in The Observer-Reporter today. I actually explained it better in the post in my blog as the letter writing has to be concise and to the point at the expense of more detailed explanations.

Stay home, save lives. Wear face coverings, stop the spread

https://doctorjytsai.blogspot.com/2020/04/stay-home-save-lives-wear-face.html

Not having the talent of our daughter, Jo, of making cloth face masks for others, to spread the useful messages of “stay home, save lives, wear face coverings and stop the spread” is the least I can do. This war can only be won when everyone participates in the fight. There is no better way to get the messages out in the newspaper.

The following is what a daughter of our family friend wrote in response to my post. It made me all the more happy as I did not send the email to her; people must have passed along my blog posts.

Her writings represents the love and concern of our adult children to us, and from one who truly understands the ferocity and viciousness of this horrendous virus, which I never observed in my entire professional career, simply put how easy one can get it.

(The following is her response)

Hi Dr. Tsai, 

Thanks for writing the post to your peers reminding them of the critical importance of STAYING HOME and if you absolutely must go to a place where there are other people, please wear a face mask. On behalf of all of your adult children and grandchildren, please make these changes in your daily lives. I know it is difficult because we are creatures of habit. We take joy in the simple pleasures in life. However, for just a short time (1-2 months, or even just the next 2 weeks), we're asking you to simply stay at home. This is the safest place to be.

This means:

- NO GROCERY STORES. If you *must* go, go during early morning hours for elderly folks, or try to space these visits out to 2+ wks, and WEAR A MASK (and gloves, wipe the handle of the cart down). Best is to have your kids setup online grocery delivery to your house for a few weeks.

- No bakeries, you don't need that pastry.

- No bank, depositing checks can wait.

- No drive through McDonald's coffee

- No Sam's Club or Costco or Target or Walmart

- If you need to get some fresh air, go for a walk around your block. Sunshine and fresh air are still good. Or call your kids if you're bored.

As you can see, my friends and I have had to call our parents every 1-2 days and YELL AT THEM FOR NON COMPLIANCE. The above are all the things we have collectively argued with parents about. The reason why we are all so adamant that you protect yourself and reduce exposure is because we know that if you get sick, 1) we don't get to stay with you at the hospital, 2) we don't get to visit you on the med floors, 3) we don't get to be with you in ICU. The absolute worst thing about covid19 is that patients are dying alone in ICU. The consequences for the elderly, immunocompromised, or those w underlying co-morbidities is simply too high to make it worth any of the above activities. Plus your grandchildren would like to have their grandparents around for a few more years if possible.

So please stay home! Wear a mask. It's just a few weeks, or few months. You can do it!

Thanks. XXXXX

The letters between T.S. Eliot and Emily Hale

My letter-to-the-editor was published in Observer-Reporter (a newspaper at Washington, PA) on January 6, 2020.  The letter was written in response to the news that the letters (more than 1,000 of them) that TS Eliot wrote to Emily Hale was unveiled after 60 years.  It was generally believed that Emily was the muse of TS Eliot, just like Beatrice was the muse (inspiration) of Dante.

After spending 8 years at Harvard, TS Eliot went to England and never returned except in 1932 when he returned to Harvard for 6-month lecture and once had a stint at Princeton’s Institute for Advanced Study.  He became a British subject, renouncing his American citizenship.

These letters were given to Princeton University library with an instruction of not to be accessible to the public until 50 years after they both died (Emily Hale in 1969, TS Eliot in 1965).  I am hoping one may find, in the over 1,000 letters, that there was a longing for everything American, in addition to saying things personal.

My letter-to-the-editor of “Why flu vaccine didn't work last year”

My letter-to-the-editor of “Why flu vaccine didn't work last year” was published at the Observer-Reporter today (12/16/2018).

On Dec. 10 the Observer-Reporter had a lengthy (more than half a newspaper page) commentary written by 3 scholars from the University of Pennsylvania (Science of Science Communication and Annenberg Public Policy Center), exhorting people to take flu vaccine. The title of the article is “Countering misinformation about the flu vaccine is harder than it seems,” a scholarly discussion as to the difficulty convincing people of the merit and the need of taking flu vaccine.

I wrote a short letter explaining why the flu vaccine didn't work as well as it was expected, lest people would lose confidence on flu vaccine.

Football game miracle

I recently wrote a post of “How can a rational medicine man accept the miracles performed by Jesus: a philosophical approach,” I had a letter-to-the-editor published in the Observer-Reporter today, talking about different type of miracle—football miracle.

It is difficult to explain the controversy of the unfair call by NFL officials unless one watched that important Patriots-Steelers game on December 17.  Here is the video of Steelers Jesse James’ touchdown reception.

https://www.sbnation.com/nfl/2017/12/17/16788458/jesse-james-touchdown-replay-overturned-steelers-patriots

My letter-to-the-editor about monoclonal antibodies in Observer-Reporter

I have another letter-to-the-editor published at Observer-Reporter today (May 14).  Last Sunday there was an Associated Press report saying the healthcare insurance companies are making innovative deals with pharmaceutical companies to make the expensive drugs accessible to the patients; the deals will enable the insurers to get extra rebates or even full refunds if drugs do not help patients as expected.  The insurer Harvard Pilgrim has had several deals.  At Harvard Pilgrim one fourth of every dollar it spends on patient care goes to prescription drugs.

My letter basically says most of the expensive drugs are made by monoclonal antibodies, which, like smart bombs, hit the target with precision.

Dr. Georges Kohler (I misspelled his name as George Kohler) died young at age of 48 in 1995.  He did see the first monoclonal antibody drug approved by FDA in 1986, although the successful (in terms of popular use and money making) drug, Remicade (a tumor necrosis factor or TNF blocking agent), was not approved until 1998.  Jan Vilcek (the author of Love and Science, a fascinating story) made a fortune from the royalty of Remicade.

There was an article in NY Times in 2012, in which it expressed a sentiment of regret that NY Times never mentioned monoclonal antibody until 1979, and yet Dr. Georges Kohler and Dr. Cesar Milstein developed the first monoclonal antibody in 1974.

Nowadays we are bombarded by the TV ad of Humira (another TNF blocking drug), which was approved in 2002.  We are spared by the TV ad of Remicade as its patent has expired.  In fact, two biosimilars (a term used for ‘generic drug’ for biologicals) of Remicade have been approved by FDA: Pfizer’s Inflectra (4/2016) and Merck’sRenflexis (4/2017).  How much the biosimilars will lower the drug prices for biologicals remained to be seen, as the cost of bringing a biosimilar to the market is 100 times that of a conventional generic drug.

Many of the drugs advertised on TV are made by monoclonal antibody technique; the list is as long as your arm.

·         Humira (adalimumab): TNF blocking agent

·         Taltz (Ixekizumab): inetrlukin-17A receptor antagonist)

·         Cosentyx (secukinumab): interleukin-17A receptor antagonist

·         Repatha (pembrolizumab): PCSK 9 inhibitor (a cholesterol-lowering drug)

·         Prolia (denosumab): to treat osteoporosis

·         Keytruda (pembrolizimab): anti-PD-1 or immune check point inhibitor; the wonder drug for President Jimmy Carter

·         Opdivo (nivolumab): anti-PD-1 or immune check point inhibitor

·         Cimzia (abciximab): TNF blocking agent

·         Xeljanz (tofacitinib): a Janus kinase inhibitor.  

Xeljanz (tofacitinib) is a Janus kinase inhibitor.  I always thought it is also a monoclonal antibody; but I could be mistaken, as a biological with a name that ends with “-tinib” is some kind of kinase inhibitor, such as imatinib (Gleevec), dasatinib, nilotinib and bosutinib are all BCR-ABL tyrosine kinase inhibitors.

The list goes on.

The drug companies spent hundreds of millions on the direct-to-consumer (DTC) advertising, they certainly hope for a handsome return; these monoclonal antibodies drugs are where money are.

An “empty” (blank space) editorial said a lot

I like the Nov. 10 Observer-Reporter’s editorial with a blank space except a print of tiny “We have no words” after the stunning Presidential election outcome.  It generated many responses from the readers, mostly praised the ingenious and eloquent or even bold move, capturing “the mood of the country”.

But not all went along, including Bill and Sally Northrop (members of the Northrop family that had owned the O-R newspaper) who’re “mortified” and felt the readers were “insulted”.  It was nevertheless an equally elegant, powerful and forceful well-written letter.

My one-sentence letter was also published today.  When professional journalists ran out of words, they said a lot, considering words are their business.

Albert Speer deserves no forgiveness: My letter-to-the-editor was published at Observer-Reporter today

On Monday (Dec. 7) a headline article reporting the story of a retired California University professor (Dr. Leonard Siegel) who corresponded with Albert Speer for 12 years after he was released from Spandau prison.  Professor Siegel also interviewed Speer for three days at Speer’s residence in Germany.

In my early days of reading WWII, I was of an opinion that Speer was a decent gentleman, among all the Hitler’s thugs, the likes of Goring, Goebbels, Himmler and Ribbentrop.  Many years of reading later, he became a sly, despicable and immoral figure.  He “escaped a death sentence by presenting a subtle and sophisticated mixture of self-exculpating [exonerating] and self-blame.”  (From Richard Evan’s The Third Reich at War.)  He obviously tricked the judge at Nuremberg trial to spare him from the noose.

Professor said Speer was “an avid gardener who turned a vegetable garden at Spandau Prison into an elaborate garden with paths, and a variety of flowers.”  He also showed the professor his garden as he did Hitler 35 years earlier.

Speer would have liked our garden, no wonder I “liked” this guy in my earlier days of reading.  Reading is to find the truth and beauty; the beauty of people, of mind and of language.  Truth is hard to come by especially reading the history.

My short letter-to-the-editor on books

I got another short letter-to-the-editor published in the Observer-Reporter today.  I commented on an article about the Great Books [of the Western World] that was published by Encyclopaedia Britannica in 1950s; the idea came from University of Chicago.

I basically said the reading should be a “balanced” one, just like the best science is the one that integrates across various fields of science.

I do not do travel reading often, but traveling leads to more reading in my case.  After coming back from London and Paris I am reading more about French Revolution, the one by Thomas Carlyle is the preferred one.  How can one not read Jean-Jacques Rousseau or Voltaire if one wants to understand French Revolution?

Seeing the house of Lady Ottoline Morrell in London reignites my interest in reading the writers of Bloomsbury Group; I am now focusing on D.H. Lawrence and Lytton Strachey, whose “Eminent Victorians” and “Queen Victoria” are free iBooks or Kindle Books that one can download, so are Thomas Carlyle’s “The French Revolution” or D.H. Lawrence’s “Lady Chatterley’s Lover”.

My letter-to-the-editor: Diversity is the key to success in nature and in human society

I wrote a very short letter-to-the-editor that was published at Observer-Reporter (Washington, PA) today May 11^th).  It was written in response to a lengthy editorial on May 7^th.  ("Wanted: More diversity in Southwestern Pa.")

It is not entirely irrelevant to quote Sir Francis Bacon who was the scientist before we even had so-called modern science while talking about biodiversity and evolution. (the first ‘scientist’ to receive the knighthood).  We owe many of our scientific concepts and methods to him.  He was always on the list of the “suspects” while they’re trying to figure out who Shakespeare was.

My letter-to-the-editor about chronic fatigue syndrome

I have another letter-to-the-editor published at the Observer-Reporter today (Feb. 2).  I basically wanted to say that chronic fatigue syndrome is the worst “poster boy” to criticize the NIH biomedical research cut back and the failure of Big Pharma to come up with the therapy for it.  The essay author (Mr. King) is apparently a fervent chronic fatigue syndrome advocate.

I use the example of BCR-ABL1 fusion gene (Philadelphia chromosome), a very specific exact science, to emphasize the stark contrast to the chronic fatigue syndrome, which remains in a “murky” state as our understanding of the disease goes. 

(the following is the letter).

I disagree with what Llewellyn King said in his essay, “The shame of biomedical research across the U.S.,” which appeared on the Observer-Reporter's commentary page Jan. 26.  In the essay, King faults the pharmaceutical companies and National Institutes of Health for their failure in developing therapy for chronic fatigue syndrome.   This reflects his lack of understanding for the potential and limits of biomedical research of pharmaceutical companies.

Dr. Janet Rowley who died Dec. 17, discovered the specific cross over between chromosome 9 and 22, resulting in the BCR-ABL1 fusion gene, also called Philadelphia chromosome, which is responsible for chronic myeloid leukemia (CML).  The subsequent development of tyrosine kinase inhibitor, such as Gleevec (imatinib), has since rendered the once dreaded CML into a chronic disease, with over 90 percent of the patients enjoying the normal life span.  This is a perfect example of the pharmaceutical companies reap what the basic biomedical research sows.

Chronic fatigue syndrome is a totally different story.  Experts have difficulty defining it.  The Center for Disease Control and Prevention (CDC) and the National Institute of Allergy and Infectious Disease have both published and revised its definitions several times.  The theories of the causes and psychopathophysiology abound, but there is no consensus.  [There is nothing for the pharmaceutical companies to tackle the problem at its roots yet.]

King lamented the cut back of NIH funding for the basic biomedical research, which, I agree, is short-sighted.  This is not to say that NIH shouldn’t fund the research on chronic fatigue syndrome, but blaming the Big Pharma at this point is missing the point.

Civil War medicine: my letter-to-the-editor

My letter-to-the-editor (Great Civil War doctors on both sides) was published at the Observer-Reporter (Washington, PA) today.  Being a Lincoln/Civil War buff and a physician; I am naturally interested in reading Civil War medicine over the years.  Harry should be considered a “contributor” of this letter as he gave me the book (Civil War Medicine) by Alfred Bollet, M.D.

The letter was a response to a feature article (‘Father of Battlefield Medicine’ was a Canonsburg native).  Canonsburg was about half an hour away from where we live.  There is presently a special exhibit (Pennsylvania Civil War, 1861-1865) at Senator John Heinz History Center in Pittsburgh.

The letter began by quoting Dr. Paul Hawley, whose story I read in Dr. Bollet’s book one day, and next day I read his story again in Omar Bradley’s autobiography, A General’s Life.  Bradley was in charge of the Veteran Administration (VA) at the end of WWII and he recruited Dr. Hawley to manage the VA hospitals system.

The only point I want to make is, like the title of the letter says, there are great American doctors on both sides during the Civil War, and the same is also true when it comes to the generals or the soldiers.

I had another letter about Lincoln a couple of years ago,

http://doctorjytsai.blogspot.com/2011/03/lincoln-was-not-abolitionist-my-letter.html

My letter-to-the-editor: Dr. Joseph Lister, our ‘savior’ in medicine

I had another letter-to-the-editor (“Giving Lister his due”) published at Observer-Reporter today (April 7). I commented on Bruce Kauffmann’s commentary last Sunday, “The medical community’s Rodney Dangerfield” (recall we often heard “I don’t get no respect” in his comic monologues) lamenting Lister didn’t get due respect from American doctors.

If the greatness in medicine is measured by the number of lives saved, then Lister is easily one of the greatest.  When Lister received a standing ovation in the Sixth International Medical Congress in Amsterdam in 1879, the President, Professor Donder, “took him by the hand, obtaining a moment’s silence, said, ‘Professor Lister, it is not only admiration that we offer you, it is our gratitude that of the nations to which we belong.’”

Dr. Joseph Lister

Unfortunately American medical community was slow to accept and adopt his antisepsis concept and technique, costing the lives of many, including President James Garfield, who died of overwhelmed sepsis and multiple abscesses (confirmed at autopsy) 80 days after being struck by an assassin’s bullet in 1881.

I don’t intend to bother you with the story of Dr. Lister, but it will be worth your while to know that the Listers spent three months of their honeymoon visiting leading medical institutions (hospitals and universities) in France and Germany.  His wife became his life-long partner in life and in Lab.

Dr. Oliver Wendell Holmes, Sr. was also trained at prestigious hospitals in Paris before being awarded a medical degree from Harvard Medical School (He is one of the people portrayed in David McCullough’s The Greater Journey: Americans in Paris).  He may be more well known for his writing than his contribution in medicine.

Listeria monocytogenes may not be a household name; but there were multiple cantaloupes associated Listeria outbreaks in 2011.

My letter-to-the-editor about the greatness of FDR

My letter-to-the-editor at the Observer-Reporter was published today (Jan. 27).  It was about the greatness of President Franklin Roosevelt (FDR).  My motive of writing it is anticipating the coming movie (Hyde Park on Hudson), which may not portray him the way I think he was.     

The editor deleted a quote of FDR’s 1941 July 4^th radio talk (5 months before the Pearl Harbor), I used it to back up some of my points.

“the United States will never survive as a happy and fertile oasis surrounded by a cruel desert of dictatorship.”

My letter-to-the-editor: support PONY League World Series

There was a piece of article (Does the PONY League World Series matter?) on the Sunday (Oct. 7) Commentary page at the Observer-Reporter (a daily newspaper at Washington, PA), to which I wrote a letter-to-the-editor that was published today.  The players in the black and white photo that accompanied the article were from Taichung (台中), Taiwan.

players from Taichung City and Iowa, August 2008

I recalled one year the hits on Katy’s blog grew by the thousands daily when she put her reports on her blog before they were published on the World Journal (世界日報).  I then lamented the hits on my blog could be counted by the fingers, I mean, of one hand.

The quote I paraphrase from Emerson is, “’Tis the good reader that makes the good book”.  Emerson basically meant, as Janice expounds, that it takes a good reader to extract the most value from a good book.  She uses the lines from Hamlet to state her case.

The paraphrasing is not entirely relevant, but that was the best I can come by to make a point that without the sports fans, there can not have a good game.

中華隊王榆銓獲大會最佳打擊獎

中華隊投手賴嘉隆8月18日擊出滿貫全壘打

My letter-to-the-editor on Ike Memorial was published at Observer Reporter today

My letter-to-the-editor to Observer Reporter was published today.  There was a lengthy editorial praising the design of Ike Memorial, which will be at the “National Mall”.  I used Lincoln Memorial to make my point.

Upon learning that Marian Anderson was denied the use of Constitution Hall in Washington because of her race, Eleanor Roosevelt made arrangement for her to sing at the Lincoln Memorial in front of 75,000 people.  Lincoln would be very pleased.

During the height of WWII, there was a powerful show of “Lincoln Portrait” at Lincoln Memorial, during which Carl Sandburg read Lincoln’s words and we heard, “we here highly resolve that these dead shall not have died in vain.”

We often heard that Churchill mobilized the English language and sent it into battle to fight Hitler (this saying was often attributed to JFK, but it was originally spoken by Edward Murrow—the great radio journalist during WWII); it is less well known that Carl Sandburg, using Lincoln’s words, did the same.

What more can I say about “I have a dream”? Upon hearing it Lincoln would have said that that was his dream, too.   

My letter-to-the-editor on having a common language at Observer-Reporter was published today

I quote Churchill to make my point and add “Hitler failed to see this.” to make a letter.  General speaking it is not a good writing if the length of quotation is out of proportion to the length of the article; but I make an exception for myself. 

Churchill’s speech at Harvard 1943 commencement was “The gift of a common tongue.” It was during the war (WWII) and it came no surprise that Harvard President Conant wanted to honor Churchill at this time of trial.  Conant’s contribution (not as Harvard president) to the country during WWII is astonishing.  I may write about him one of these days.

Upon learning Harvard was to honor Churchill in 1943, FDR wanted his alma mater to make sure all the pomp and color would be there.  When James Watson was invited to Harvard for an interview to join the faculty.  He felt more reassuring when he found out, by glancing at the guest signature book, that he was placed in the same room where Churchill stayed in 1943.

Rapturous and riotous roar: My two-sentence letter-to-the-editor at Observer-Reporter

I selected two sentences from a FB post of my comment on royal wedding and sent it to the Observer-Reporter and the editor must have agreed that it is worth reading.

I am pleased I used the “rapturous and riotous roar” (three R’s, alliteration, that's it); this is a joyful occasion that might even evokes ecstatic feeling on some, thus ‘rapturous’, the fact that the little girl covers her ears, saying it must be a clamorous uproar, thus appropriate to say ‘riotous roar”, given the size of the crowd.  This is also my lighthearted attempt to justify the ‘not-happy-looking’ girl photo to fit the happy occasion.

Lincoln was not an abolitionist: my letter-to-the-editor to Observer-Reporter

The other day I said, “you may argue with 英毅 about anything, but certainly not photography; when he talks about photography, you listen.” and 英毅 responded by saying, “you may argue with Jer-Yuan about anything, but certainly not Abraham Lincoln; when he talks about Abraham Lincoln, you listen.” And I am glad the editors at the Observer-Reporter (O-R) also listen as my letter-to-the-editor about Lincoln was published today (March 3).

I tend to write very short letter: a paragraph or two or just a few sentences. But, I do have a lot to say about Lincoln and the topic of interest calls for a lengthy one. The lengthy editorial (Feb. 27) basically said their newspaper (The Reporter and Tribune—an earlier manifestation of current O-R) was on Lincoln’s side; but if they took the stand of a radical abolitionist, which I cannot tell by reading the editorial alone, then they might be on Lincoln’s side, but they’re standing to the right of Lincoln.