March 8, 2021

COVID-19 Update

Good morning.  As the Coronavirus situation continues to improve, we hope all of you are safe and well.  Today let’s take a moment to talk about vaccines.  

This past week patients in El Paso began receiving the Janssen COVID-19 vaccine.  Similar to AztraZeneca, this vaccine uses DNA to instruct our cells to make bits of the spike proteins that cover the Coronavirus.  Most of us have heard about DNA and mRNA vaccines, but how do they actually work?

There is a constant battle between our bodies and the hoards of invaders that seek to get in and steal our resources.  Bacteria, which are single cell living organisms, would love to breach our defenses and set up microbial homesteads in our territory.  In fact, there are about 100 trillion bacteria living in our digestive tract alone.  In response, 70 percent of the human immune system is there, defending us from relentless attack.  

Our immune system uses a variety of mechanisms to identify invaders and to distinguish them from our own cells.  Of these one of the most important is the antibody.  

When a new invader is identified, our immune system deploys weapons that tag and kill.  Identifying features from the surface of the invader are then copied and made into antibodies.  Antibodies are a little like nature’s “mug shots”.  These get distributed throughout the immune system allowing our defenses to recognize a particular invader even if that particular immune system cell has never seen it before.  The mug shots (identifying features) are unique shapes that are stuck onto the outside of invading cells and are made of protein.  The zoomed in part of the picture below is a protein chain folded into a specific complex shape. The ingredients in the protein determine how the protein folds. Its final shape is unique somewhat like a fingerprint.

Here’s where things get interesting.  Incredible breakthroughs in genetics have led to the understanding that all proteins are made from recipes encoded in our DNA.  Think of DNA as the recipe book to make you.  In each of our cells lies a set of instructions that is so perfect and complete that, if read in its entirety and followed to the letter, makes a perfect copy of you (or any other living thing).  One of the most important recipes contained in our DNA is the protein.  Proteins form the structural components of many of the most important parts of our cells and our bodies, including antibodies.

To make proteins, our cells read the recipes contained in our DNA and transcribe the information from this master recipe into a smaller memo called messenger RNA or mRNA.  Our cells then read the memo contained in the mRNA and make the exact protein called for.  

And this is how the mRNA vaccines work.  Because genetic research has come so far, scientists are now able to take bits of COVID-19 and “read” the proteins that cover its surface.  Like the Rosetta Stone, they then translate the protein backwards into mRNA.  This would be sort of like being able to work out the ingredients in a cake from a single bite.

The Moderna and Pfizer vaccines contain copies of mRNA that instruct our cells to make pieces of COVID-19 spike proteins.  These fragments are then recognized by our immune system as pieces of killed invaders which triggers the production of mug shots (antibodies).  In Rosetta Stone terms, mRNA is like translating Egyptian hieroglyphs (pictures) to Egyptian demotic (symbols)—2 steps.

The Janssen and AstraZeneca vaccines take the process one step further.  Instead of directly providing the mRNA memos to make proteins, these vaccines send pieces of the master copy—DNA.  Providing DNA is one step higher or removed in the protein making process but is otherwise identical.  In both cases, whether mRNA or DNA, our bodies use essentially the same recipe to make pieces of Coronavirus spike proteins.  In Rosetta Stone terms, DNA is like translating Ancient Greek to Egyptian hieroglyphs (pictures) then to Egyptian Demotic (symbols)—3 steps.

How are the vaccines different then?  One of the most important differences is that DNA is a stronger molecule than mRNA and can hold together at higher temperatures. Messenger RNA is quite fragile and even exposure to water can cause it to disintegrate. However, mRNA is a more direct method of getting our bodies to make spike proteins and seems to be somewhat more effective.  That said, both types of vaccine appear to prevent nearly all hospitalizations and deaths from COVID-19.  Anyone able to get any of these vaccines should count themself lucky!

Stay well!

CG Escandon, MD

Douglas Payne, MD

COVID-19 Information

For the week of 3/8/2021

Assumptions:

• Mortality rate between 1.5% and 0.5% — using 0.75%

• This means 1 death for every 133 infections

• For March 7 — 2,187 total deaths = 291,000 total cases

• 47% or 549,000 El Pasoans have not been infected yet

• The number of deaths lags behind the number of infections by 2-4 weeks

• We estimate the current infection rate to be higher than stated as of March 7th

Assumptions:

Staffed Hospital Beds: 1754

Available Hospital Beds: 572 (1/3 of total)

Staffed ICU Beds: 234

Available ICU Beds: 77 (1/3 of total)

December 29, 2020

COVID-19 Vaccine Update

Good morning. Some quick tips as we head into the New Year break. In the last vaccine newsletter we published a list of providers that had been approved to receive the Moderna vaccine. We have heard some patients were able to get appointments. Please try these and let us know if you are successful.

Mountain West Family Medicine (915) 584-8124
Immunize El Paso East (915) 857-2474
Texas Tech Physicians of El Paso Transmountain (915) 215-8400
El Paso Pulmonary Association (915) 532-2477
Family Medicine Associates of El Paso (915) 594-1033
EP Family Doctor (915) 855-7000
Dr Lipanova (915) 751-5245
Dr Calianga (915) 592-6868

University Medical Center West and other UMC sites will continue vaccinating patients with risk factors. This includes those 75 and older or 18 and older with chronic illness (diabetes, obesity, asthma, immunodeficiency, etc). Please call for appointments or to be put on the waiting list (915) 544-1200 or (915) 975-8900.

The City of El Paso Department of Public Health will roll out vaccine for additional groups over the next few weeks. You can follow the status here:
http://epstrong.org/vaccine.php.

Please get vaccinated as soon as you can!


CG Escandon, MD
Douglas Payne, MD

COVID 19 Testing:

We recommend patients obtain a home test kit from LabCorp.

This is a home nasal swab kit and is the same type as the City of El Paso’s test.

It is covered by insurance and there should be no cost.

Go to:

https://www.pixel.labcorp.com

Local testing has been expanded and is now available to anyone with or without symptoms.

Some patients have been turned away without a doctor’s order—call us if this happens and we will text or email one.

(Testing policy changes frequently so check EPStrong website often)

http://epstrong.org/testing.php

All via drive through testing. There is no cost.

Call (915) 212-0783 for information

or

WWW.TXCOVIDTEST.ORG or by calling 512-883-2400

Again, please do not leave your home unless you absolutely have to

How to deal with leaving the house or receiving a delivery:

Treat your home as a “clean room” = Don’t let germs enter

Going out

• Wear clothes that can be washed in hot water—preferably with bleach

• Wear a mask (N95 if you can)—Casa Medical (915-833-2272) has them

• Carry hand sanitizer and use if often—especially after touching something

• Do not touch your face

• Wipe down anything you touch in your vehicle

Returning

• Create a “contaminated space” in your garage or entry area

• Remove shoes and clothing in the contaminated space

• Take clothes immediately to washing machine and start cycle

• Shower before moving about the house

Deliveries

• Keep at least 6 feet distance from person making delivery

• Wipe down all items before bringing inside

• If non-perishable items can be left for a time without touching, this will decontaminate

  • Paper or cardboard 48 hours

  • Plastic, glass or metal (hard surfaces) 72 hours

  • Leave items that can handle the sun in direct sunlight for 15 minutes per side

• Wash your hands, clothes and shower as above

  • Remember this includes mail and packages—try to let them sit for 2-3 days before opening