- Jonathan Howard is a neurologist who works at Bellevue Hospital in New York City. During the epidemic, he led a team of healthcare workers treating Kovid-19 patients.
- Howard says he jumped at the chance to join the AstraZeneca vaccine trial because he had a long-standing fascination with vaccines and the anti-vaccine legends around him.
- Howard explains that although COVID-19 vaccines were developed this year, years of work had already been done on the safety and effectiveness of similar vaccines, so scientists did not start from scratch.
- While there is still a lot to learn about how vaccines will work when they are distributed to millions of people, Howard says vaccines also have unexpected benefits, just as we did in the past.
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As a neurologist, who specializes in the treatment of multiple sclerosis, vaccine and vaccine Rocky diseases, it does not play a significant role in my professional career. Although I have seen polio and measles, the only vaccine-preventable disease I have seen regularly with pre-COVID-19 was shingles.
When the first wave hit New York City I planned to staff Bellevue Hospital’s Neurology Consult Service. Although some patients suffered a devastating stroke, overall it was relatively calm from a neurological point of view and we had very little to do. To the amazement of others, it seemed that during the COVID-19 spike each disease disappeared for a month. As cases have been taken, I became infected to run on the floor team caring for COVID-19 patients. All patients at the regular clinic were moved to a video interview.
To be honest, most COVID-19 patients had no big deal except to give them oxygen oxygen and hope for the best.
We will do our rounds, offer what we can to make them comfortable, and encourage them to sleep in the most likely position, as there is some evidence that can help them breathe. I have also ensured that none of the patients on my team received any experimental treatment (such as hydroxychloroquine). It is always very difficult for doctors to do “nothing”, but it is better to give inadvisable treatment until patients clearly die or come to a clinical trial. If patients were getting better, we would discharge them. If they were bad, we would send them to the ICU. Rarely did we return in the morning to find out that a patient had passed out at night.
Even before the epidemic came I was honestly the most stressed, taking ways and frequent dreams of nightmares of patients on the streets. I started taking medication to help me sleep for the first time. While such scenes were seen in some patients, our emergency room was relatively quiet for most of the day and most of our patients were transferred from other hospitals, thus avoiding large-scale chaos. Still, the hospital hospital’s intercom was the busiest I had ever heard, with calls coming in for the “airway team”, which seemed to be throbbing throughout the hospital every five minutes. I saw as many as 23 young patients die alone, with no one beside them.
I was also concerned about my own health and the health of my team.
It turns out that P.P.E. Works really well and most healthcare workers who contracted COVID-19 did so at home or from other healthcare workers in workrooms or cafeterias. However, this was not clear during the early stages of the epidemic, and like all healthcare workers I wondered if I was bringing any deadly virus into my family.
I have been fascinated by vaccines and people ever since a former colleague of mine came up against vaccines unnecessarily. This inspired me to learn more about vaccines and surrounding legends. I also wrote a chapter on the anti-vaccine movement in a book about pseudoscience.
The most common belief about vaccines is that they Not properly tested For safety.
Had argued for years that the vaccine is properly tested, so I personally jumped at the chance to participate in the vaccine trial. I have always believed that people who participate in medical research do noble work. If one does not volunteer for such research, medicine will never move forward.
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I got my first shot of the vaccine or placebo at Bellevue Hospital in mid-November.
Howard received a vaccine or a placebo shot as part of the AstraZeneca trials.
Jonathan Howard
Although I work at Bellevue Hospital Hospital, I still had to enter the study by filling out a general online form for those interested in taking part in vaccine tests. I was sent information about the trial and what to expect on the first visit.
My experience so far has been pretty boring, which is of course good news. My first visit on November 19 lasted just over an hour. I had a full medical history and a physical exam, which luckily was too short for me. I was tested for Covid-19, given some snacks, and then got a shot.
Although I don’t know of course if I’ve got a real vaccine or a placebo, I’m sure I’ve got a real thing.
The next day I felt very rotten: I had a sore throat, low fever, muscle aches and a headache. This lasted for about 24 hours, except for the sore hands, which lasted for a few days. Given the horrors I saw during the boom in New York, this was a modest price to pay for the ultimate goal of developing the COVID-19 vaccine.
I am going to take my second dose on December 18th. In the meantime, I have to check through the weekly Question No Questionnaire to see if I have any symptoms. Staff is available 24/7 if I have any questions or problems.
Although I am confident that I have little protection against COVID-19, I have not changed my behavior at all. I’m not entirely sure I’ve got the actual vaccine and I have yet to take another dose. Even after this I will be careful. No vaccine is completely effective, and it is possible that this vaccine will protect people from disease, but not from spreading the disease to others.
The Ast Strazeneka trial I am conducting is the Phase 3 trial, which is the largest trial to determine whether the vaccine is really safe and effective.
However, even before the vaccine came into my hands, years of work had been done on the safety and effectiveness of this type of vaccine. The AstraZeneca vaccine is an adenovirus-based vaccine that uses a harmless, modified cold virus to induce an immune response to CARV-2, the virus that causes COVID-19. Overall the vaccine seems to be about 70% effective, although unexpectedly, low doses of the vaccine appear to be more effective than high doses. Why it is unclear and needs to be confirmed in a larger study.
It is also a relatively inexpensive vaccine (less than $ 4 per dose) and does not require storage at extremely low temperatures. Overall research on vaccines for coronavirus has been going on for years, and a vaccine using the same technology using G has previously been approved for Ebola. So, fortunately scientists weren’t starting to design these vaccines from scratch – another reason why progress has been so rapid this year.
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Even when the Phase 3 trials are completed, we will continue to learn a lot about them.
Although they appear to be very effective in clinical trials so far, we need to see if these are contained in the “real-world”. While the vaccine is extremely effective in preventing the disease, no one knows that people can remain asymptomatic carriers, and that the disease can spread to others. It is unknown at this time what he will do after leaving the post.
Additionally, rare side effects can only be revealed when millions of people have been vaccinated, although determining efficacy is difficult outside of a controlled trial. After all, if we give a cookie to 100 million people, some of them are likely to have unexpected negative side effects or reactions.
We can also learn that the COVID-19 vaccine has unexpected benefits. The measles vaccine, which dates back to the 1960s, was recently shown to protect against other infectious diseases.
Given these unknowns, anyone who gets the Covid-19 vaccine will somehow contribute to medical research. And of course, we’ll actually learn about the long-term side effects of COVID-19 over the years. The lives of many survivors will be permanently changed by this virus.
Overall, I am very optimistic about 2021 and by summer or autumn, we should gradually return to normal.
Completion of multiple successful tests for a new virus under one year is undoubtedly one of the greatest scientific achievements in the history of medicine. The hardest part is maybe getting the vaccine delivered to people around the world and persuading them to take it. Still, I am proud to play a small role in this project.
Jonathan Howard is an associate professor of neurology and psychiatry at the NYU Langone School of Medicine and a neurologist at Bellevue Hospital. Follow him Twitter.
