Fast 5 months since the first diary of The Dose was published by JtC. The request was made to the weekly Open Threaders to post one for COVID discussions in addition to our regular regular diary.

For the most part I had been able to ignore the COVID issues, others covered the subject adequately. My personal plan was developed in April 2020 with the intent to follow for about 2 years then reevaluate based on contemporary pandemic info. Per info supplied by C99 participants added povoiodine gargle and nasal spray after being in high risk locations and have built a robust portable air filter system to move into a building or room when visitors can not stay outside. The N95 mask used on town trips since February 2020 has been reclassified by the CDC as a respirator. Fits the current theme masks do not provide adequate protection, so why bother.

The scope of conversation and various approaches to gathering information has been interesting. Watching the development of C99 members mastering a subject, learning new skills and expanding perspectives provides me hope for the future. I will continue to populate The Dose with a wide variety of sources, subjects, opinions and a few research articles. If your perspective is not covered add a comment, write a diary or offer to host a weekly Open Thread and The Dose for a while. Rules are simple no insults.

My evaluation of drug therapies does contain some biases developed in the 20 plus years primarily practicing in a sub-specialty of pharmacy: medication management and drug information services. First, drugs are the cause of multiple health complications. Sometimes there are no other treatment options and the complications need to be endured. Ignoring patient observations, discomfort or harm should not be the default position. Second, is financial benefit to pharmaceutical manufactures, insurance companies and medical providers (including institutions such as hospitals) are a primary consideration as to the drugs choices available for patient treatment. Third, patients deserve to be considered as an individual not a data point for a research project. Fourth, One-size-fits-all does not work with clothing, it definitely does not work with medical treatments and disease protocols. Fifth, medical standards change, sometimes abruptly. Some of those changes starts with medical practitioners or patients noticing treatment failures and trying other options.

Full disclosure I no longer have a public practice and keep up on all aspects of drug therapies. Decided to step away from the business when my Dad was offered hospice the week after Mom's funeral. Turned out to be a seven year journey. Hiring someone to run the farm and going back to the constant traveling is not very appealing.

A few articles of interest.

For those more comfortable with general information from a mainstream news source the NPR's The Coronavirus Crisis page offers "Everything you need to know about the global pandemic"

The coverage on the FDA requested application for the Pfizer vaccine in children under 5 years has been robust.

Pfizer asks FDA to allow COVID-19 vaccine for kids under 5

Pfizer on Tuesday asked the U.S. to authorize extra-low doses of its COVID-19 vaccine for children under 5, potentially opening the way for the very youngest Americans to start receiving shots as early as March.

In an extraordinary move, the Food and Drug Administration had urged Pfizer and its partner BioNTech to apply earlier than the companies had planned — and before it's settled if the youngsters will need two shots or three.

The nation’s 19 million children under 5 are the only group not yet eligible for vaccination against the coronavirus. Many parents have been pushing for an expansion of shots to toddlers and preschoolers, especially as the omicron variant sent record numbers of youngsters to the hospital.

FDA to share data on how effective the Pfizer vaccine is for kids under 5 NPR Feb 11, 2022

Parents of young kids waiting for a vaccine, it's getting closer. Today we will all find out how well the Pfizer-BioNTech COVID-19 vaccine works in children 6 months to 4 years old. NPR has learned that the companies have gathered additional data to support their request for this authorization. The Food and Drug Administration is expected to release that data today.

Unfortunately the release of the additional data to the public regarding the vaccine trial in those younger than 5 years will be delayed.

The FDA postpones a highly anticipated meeting on the Pfizer vaccine for young kids

A highly anticipated meeting of expert advisers to discuss whether to recommend the use of the Pfizer-BioNTech COVID-19 vaccine for young children has been postponed.

The Food and Drug Administration said Pfizer told the agency that new data have recently emerged regarding its emergency use authorization request for the Pfizer vaccine in children 6 months through 4 years of age.

The agency said its preliminary assessment and need to allow more time to evaluate additional data led it to postpone the meeting scheduled for Tuesday, Feb. 15.

There Is Nothing Normal about One Million People Dead from COVID Scientific American Feb 10, 2022

If you’re trying to get people to accept that what the nation is doing right now is okay, and 50,000 deaths per month should be normalized, then it’s rational.

If you don’t want people to wonder why in just two years, the U.S. death toll for COVID is about 130 percent the size of the death toll of four decades of HIV—while global COVID deaths are less than 20 percent of the world’s AIDS deaths—then it’s rational.

If you want to manufacture consent for looser pandemic measures in the U.S. rather than more comprehensive ones as the communal viral rate demands, then making these claims is rational.

But it’s not ethical to manufacture what I call a viral underclass, and it’s incorrect to pretend as though the news media have no role in creating it nor in persuading the public that so many deaths are inevitable.

It’s a shame that major news outlets are talking more about moving on and returning to normal, and not running more pieces calling for an increase in government-funded mitigation efforts (more free high-quality masks and tests, upgraded ventilation in worksites and schools) to stem the tide of death. American norms (rampant incarceration, eviction, homelessness, lack of health care, poor ventilation and economic inequality) are fairly deadly as is.

How Long Will Taiwan Stick to Its Zero-COVID Approach? The Diplomat Feb 3, 2022

Consequently, while the outbreak seems to have been contained for now, it has raised questions about whether Taiwan will maintain its current zero-COVID strategy or not. Much international reporting has zoomed in on China as the primary example of a country that has continued to pursue a zero-COVID approach, but Taiwan has also maintained this strategy. However, Taiwan has primarily done this through voluntary measures and the widespread use of contact tracing, rather than the snap lockdowns used in China, which have sometimes been deemed authoritarian.

In Taiwan, government officials otherwise politically at odds – ranging from Minister of Health and Welfare Chen Shih-chung to Taipei mayor Ko Wen-je – have spoken of the need to eventually co-exist with COVID-19 since last year. There has been some recognition of the need to eventually accommodate COVID-19 from the onset.

That being said, when questioned by the media, Chen has stated that the CECC continues to adhere to a zero-COVID approach and that it believes Omicron can still be contained through a test, trace, and isolate regimen. Yet the CECC does not rule out that in the future, this approach might fail to contain more infectious variants of COVID-19.

Looking forward to seeing additional comparisons of various vaccine types.

CORONAVIRUS/Over 975,000 appointments made for COVID booster shot online in 7 hours Focus Taiwan Jan 26, 2022.

Beijing’s ambitious Olympic COVID bubble: So far, so good AP Feb 11, 2022

For a country determined to keep out the virus that first emerged within its borders, bringing in more than 15,000 people from all corners of the world was a serious gamble. It appears to be working.

One week into the 17-day event, China seems to be meeting its formidable COVID-19 Olympic challenge with a so-called “bubble” that allows Beijing Games participants to skip quarantine but tightly restricts their movement so they don’t come in contact with the general population. There have been 490 confirmed cases — many of them positive tests on symptomless visitors — and no reports of any leaking out to date.

Inside the bubble, Olympic organizers are employing a version of the government’s zero-tolerance approach. Everyone is tested daily for the virus, and anyone who tests positive is rapidly isolated to prevent any spread. Athletes and others are required to wear N95 face masks when not competing.
...
China has had scattered outbreaks in the past month, but none related to the Olympics. On Friday, health authorities reported 22 new cases in an outbreak in Liaoning province, east of Beijing.

None of the 450 confirmed infections inside the loop have spread to others in the bubble, Huang Chun, a pandemic control official, said earlier this week. And there have been no reports of anything medically serious.
...
The final test will come after the Games, when thousands of Olympic staff and volunteers from China exit the bubble. They are expected to be required to quarantine for a week or more before leaving to try to forestall the effects of any latent infections they might have.

Source supplied by Pluto's Republic
Vitamin D for COVID-19: real-time meta analysis of 169 studies

Introduction
We analyze all significant studies regarding vitamin D and COVID-19. Search methods, inclusion criteria, effect extraction criteria (more serious outcomes have priority), all individual study data, PRISMA answers, and statistical methods are detailed in Appendix 1. We present random-effects meta-analysis results for studies analyzing outcomes based on sufficiency, for all treatment studies, for mortality results only, and for treatment studies within each treatment stage.
Vitamin D.

Vitamin D undergoes two conversion steps before reaching the biologically active form as shown in Figure 2. The first step is conversion to calcidiol, or 25(OH)D, in the liver. The second is conversion to calcitriol, or 1,25(OH)2D, which occurs in the kidneys, the immune system, and elsewhere. Calcitriol is the active, steroid-hormone form of vitamin D, which binds with vitamin D receptors found in most cells in the body. Vitamin D was first identified in relation to bone health, but is now known to have multiple functions, including an important role in the immune system [Carlberg, Martens]. For example, [Quraishi] show a strong association between pre-operative vitamin D levels and hospital-acquired infections, as shown in Figure 3. There is a significant delay involved in the conversion from cholecalciferol, therefore calcifediol (calcidiol) or calcitriol may be preferable for treatment.
...
Conclusion
Random effects meta-analysis with pooled effects using the most serious outcome reported shows 81% [53‑92%] and 40% [32‑47%] improvement for early treatment and for all studies. Results are similar after restriction to 58 peer-reviewed studies: 77% [45‑90%] and 41% [33‑48%], and for the 38 mortality results: 76% [37‑91%] and 41% [28‑52%].

Statistically significant improvements are seen in treatment studies for mortality, ventilation, ICU admission, and hospitalization. 31 studies from 28 independent teams in 13 different countries show statistically significant improvements in isolation (23 for the most serious outcome).

Late stage treatment with calcifediol/calcitriol shows greater improvement compared to cholecalciferol: 73% [57‑83%] vs. 46% [26‑60%].