By Dr. Anthony Policastro

One thing I learned as a Commanding Officer in the military is that the buck stops at the commander’s desk.

If is it something good, the commander often gets praise for all the work those in the unit have done. If it is something bad, the commander needs to stand up and take the blame.

We have seen examples of that recently.

At Ford Hood earlier this year an army Specialist was bludgeoned to death.

The investigation led to the firing or suspension of 14 individuals. They did not wield the weapon. However, they were responsible for setting up an atmosphere where that could have happened.

Earlier this year Captain Brett Crozier was fired as Commander of the aircraft carrier Theodore Roosevelt. He was concerned about the well-being of the men and women assigned to his unit.

However there were issues with following chain of command. Ultimately he paid the price, but his efforts helped those of his crew who were sickened by COVID-19.

It is called accountability. President Harry Truman is credited with popularizing the term “The Buck Stops Here.” It is odd that he was the one to do so. He was a politician.

We often see politicians taking the path of least resistance. It is part of their way of thinking. They know that they need to share good news in order to get re-elected. Therefore, that is what they try to do.

They take credit for good things. They distance themselves from bad things. It is not intentional. It is the way we behave as human beings.

Therefore, it is not a surprise to find that kind of thinking. We need to realize that they are like the rest of us in that way.

We have had two good examples during the present COVID-19 epidemic.

Everyone wants to take credit for the treatments that scientists have developed. They might be vaccines. They might be medications. Those things were done in laboratories.

Politicians never set foot in those labs. They would have happened regardless of political actions.

On the other hand we have one of the highest death rates in the world. There is a lot of finger pointing related to that.

However, all the fingers are pointing away from the people doing the pointing.

The politicians cannot take all the blame for it. However, they also must be held accountable for those actions which contributed to the high death toll.

It would be interesting to see what would happen if the government were a military organization.

Who would be held responsible for the good and the bad? Who would be the one to lose their job and be reassigned?

We will never know. The one thing we do know is that the buck has to stop somewhere.

COVID-19 UPDATE

Nationally the number of new cases continues at a high level. For most of November the numbers remained at between 140,000 and 200,000.

However, since December 2nd the number of new cases has been between 180,000 and 254,000. So we appear to be at a new higher plateau.

Locally, we are seeing the same thing. The May surge in Sussex County accounted for about 1,400 cases in a 14-day period. For the most recent 14-day period we have had about 1,800 cases.

FDR described the attack on Pearl Harbor as a “day that will live in infamy.” On that day 2,403 Americans were killed.

The terrorists attacks on September 11th resulted in 2,977 victims. Both of those events are forever etched in our memory. The loss of life was dreadful.

We have become somewhat accustomed to the COVID-19 death toll.

On Wednesday Dec. 9, there were 3,124 COVID deaths. That is more than either of the other two tragedies. It is not likely that December 9th will be etched in our memory. It should be, but it won’t.

From May to November we had the ninth highest death rate in the world. So as a country we did a poor job of keeping people from dying.

I reported two weeks ago that the current surge had taken us from ninth place to seventh place. During the last week we moved ahead of Argentina into sixth place.

We have now had more deaths per million people than all but five other countries.

Only Belgium, Peru, Italy, Spain and the United Kingdom have done a worse job than we have in preventing mortality from COVID-19.

As I have repeatedly said there are multiple factors that are causing this. As a nation we clearly have not addressed enough of them.

The big news this week is the arrival of the Pfizer COVID-19 vaccine. Its use began in the United Kingdom. That was followed by Bahrain and Canada. The United States was fourth to give it the green light.

During the Pfizer vaccine trials, they did not test the vaccine on individuals with a history of significant allergic reactions. That is how testing is normally done.

However, they gave it to all people regardless of medical history when they started doing so in the United Kingdom.

On the first day two people with a significant allergic history had anaphylactic reactions to the vaccine. They were both treated and did well.

Therefore, there is now a warning related to the Pfizer vaccine. The warning addresses anyone with a “significant” allergic reaction to a vaccine, medicine or food.

Significant is defined by those who have either a history of anaphylaxis or who carry an Epipen.

Those individuals should not receive the Pfizer vaccine. There are not many of them in the general population.

People with routine food or medication allergies need not be concerned.

I have had about 20 Epipen injections for my wheat-related exercise-induced anaphylaxis. So I am one of the few individuals in the high-risk group. I guess I won’t be taking the Pfizer vaccine.

This is an example of knowing about the individual risks related to the specific vaccines.

As I have said before Pfizer and Moderna vaccines are based upon mRNA (messenger RNA). This is the first time we are actually using mRNA vaccines.

There are those who are skeptical of the “new” process. However, it has been in the works for 30 years.

The mother of mRNA vaccines was Katalin Karikó. She started her research at the University of Pennsylvania in 1990.

In 2005 she found a partner who helped her figure out how to make it work. In 2009 the first artificial mRNA was created.

The following year that group of researchers made their presentation and formed Moderna. The company was essentially formed 10 years ago to make mRNA vaccines.

There are now four types of vaccines. The mRNA vaccines uses lab manufactured mRNA. That allows the body to develop antibodies to that protein. Pfizer and Moderna do that.

There are vector vaccines. They use another virus (the vector) to carry COVID type proteins. Adenovirus (common cold) is a common vector. AstraZeneca and Johnson and Johnson do this. The Russian Sputnik vaccine is also of this type.

There are protein subunit vaccines. They use pieces of the protein that they have grown in insects. Novavax makes this type.

There are inactivated virus vaccines. These are traditional in nature. Coronavac and the one made by SinoPharm use this technique. They are both based in China.

Vaccine myths abound. There are some people trying to claim they make women sterile. That of course is bogus.

There are some trying to claim that they are injecting mind-reading devices for the government to track your thoughts. Really???!!!

One question that is clearer is the timing of protection after vaccines. It usually takes the body about two weeks to make antibodies to an infection or an immunization.

That means that there should be protection two weeks after the second dose in a two-dose regimen.

We know that for traditional vaccines you are protected if you are exposed to the organism at a later date.

We also know that you cannot shed the organism at that time. It is likely that the same thing will be true for the newer type vaccines.

However, we will not know for a while if the protection is full or not. The newer type of vaccines will protect you against symptoms if the virus infects you. What is less clear is if they will keep you from infecting others at that time.

Until we know the answer to that question, masks and social distancing will continue to remain necessary even for vaccine recipients. This is another plus for vaccines like Coronavac.

Back in 2015 I had pneumonia. The antibodies I developed to the pneumonia thought my platelets (blood clotting cells) were pneumonia cells. So they started destroying my platelets. That caused a temporary bleeding disorder.

This type of illness is called autoimmune disorder. Your immune system actually attacks your body’s cells.

A new study from Yale suggests that individuals with the most severe cases of COVID-19 infection may have a similar issue. The antibodies they make to fight the disease might actually be attacking their own organs thinking they are COVID-19 cells.