Tag: COVID-19

EU Digital Passenger Locator Form (dPLF)

This is a form that all visitors to EU countries had to fill out previously. However, most countries have stopped requiring this form, except for Malta, Slovenia, and France. Since we are visiting Italy and Paris on our trip, we need to fill out this form.

I started filling out this form on my iPhone using Chrome browser. Since we are stopping in Italy first, I did not know what the form wanted for origin. Italy? United States? United Kingdom (London transit)? Finally, I decided to enter all our flights, including the return flights.

The form asks for a lot of information, including flight and seat numbers. After each flight is entered, you get options to enter the next flight and [Temporary Save]. I did hit save after the first flight but skipped that step going forward. Of course, the webpage decides to crash and freeze on the fourth flight data entry, so I went over to my MacBook to continue. The app did save something, but it was missing random fields for the first flight, and all subsequent flights.

Ugh.

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Done. Luckily I could add family members traveling together so my sister’s family do not need to fill out this ugly form.

Also, whenever you see an option to temporary save on a webform, click it. It is like a save point before you encounter a boss monster in a game. You need to save because you will fail and need to return to your save point.

Italy and France COVID Cases 6/4/2022

Since the EU case rate map is a live link, it will show the same data as the previous post. If you look at the COVID data on Google/NYT, the number of cases in both countries continues to drop.

Italy

France

Like the previous charts I snipped for both countries, Italy’s case count is still decreasing while France is holding flat. Again, for comparison, here is the case count for Los Angeles County.

Since our work is asking people to return to the office, this trend is positive as well. I have a medical exemption to work from home, but I still feel more effective if I am onsite so I will likely go back in the office two or three times a week when I return from Europe.

Italy and France COVID Cases

I just posted about this about a week ago, and the EU map is already different. The most recent map has a larger portion of France in orange instead of red. Italy is still in the highest positive case rate category, but the graph is still showing a downward trend. For both France and Los Angeles County, the case rate is flattening out, though they are on the opposite sides of the Omicron BA.2 spike.

Live(?) link to the EU case rate map

I am going into the office this Thursday so I can meet in-person with a few people to delegate my responsibilities for the next two plus weeks. It does look like our trip is on; I just need to review all the COVID restrictions for each county once more and see if there is additional paperwork to fill out.

EU Travel Restrictions

https://reopen.europa.eu/static/weekly-map.png

We are about a week away from our trip to Europe, and both Italy and France are in the >300 cases per 100k people per day category. I did research all the travel restrictions currently enforced in Europe, and we can still travel without any COVID tests or quarantine if we are vaccinated. I hope our cheapo CDC white cards are sufficient.

Even though case counts are still high in Italy and France, the number of daily new cases is decreasing. Here are charts for both countries over the past three months.

The big hump for both countries is likely the Omicron BA.2 variant. In Europe, there was not really a break between the BA.1 spike at the beginning of the year, and the second spike. In the US, cases died down quickly but is on the rise again from BA.2.

This is just Los Angeles County so the y-axis scale is totally different. However, you do see an increases in the number of cases while it is clearly decreasing in Italy and France above. I am hoping that cases will continue to drop in Europe during the next week so we will be a bit safer on our trip.

I do feel a bit embarrasses that I am going to a fairly high risk area for vacation, while I am working from home due to the increasing number of cases locally.

Zero-COVID in China

I know someone in Beijing right now and they must do a PCR test daily for the past two weeks. Not sure when or if the testing will end.

At the beginning of the pandemic, some of the quarantine methods used by the CCP were justifiable, if not a bit harsh. But with Omicron and what happened in Shanghai during the past few months, it has become absurd political theater,

More Posts…

One of my three readers mentioned the lack of content so I will post more. I actually had a lot of ideas for posts but work was a bit busy so I ended up doing work stuff.

I am working everyday from home again. COVID cases are on the rise, like due to Omicron v2.0 or v2.1. When I decided to start returning to the office in mid-March, there were about 800 cases per day in LA county. Now it is over 3300 per day. Ugh.

Just to reinforce the point, a bunch of people got sick over the weekend. Three out of the six sick coworkers tested positive for COVID.

I am also watching the case trend in Italy and France since we are still planning on going to our European trip in three weeks. It does appear that Omicron v1.0 and v2.0 spikes were closer together, and both countries currently show a decreasing trend.

Back to the Office?

I have worked at my current company for almost eleven years. However, it feels much shorter than that since I have been working from home, both full-time and part-time, for several years. When I first started doing in-clinic hemodialysis, I “unofficially” worked from home two days each week. At the time, my dialysis sessions were from 1:00 pm to 5:00 pm so I worked in the morning during dialysis days, then made up the hours at night or on the weekend, while taking the occasional vacation day. I went back to work in the office full-time while on peritoneal dialysis, then “officially” part-time (30 hours/week) after heart surgery and switching back to in-clinic hemodialysis.

I remember about two years ago, in March 2020, the COVID-19 pandemic finally hit Los Angeles, and our department was told to go home. At the time, many people thought the pandemic would last a few weeks, perhaps even a few months. Here we are two years later, and the pandemic still rages on. Here are some charts tracking COVID cases in Los Angeles County:

Daily new cases for the last 24 months
Daily new cases for the last 6 months

Given that I have had four Moderna COVID vaccine shots and the latest dosage of Evusheld, plus the sharp decrease in the number of new cases, I feel I can start going back into the office one or two days each week. I did pose this question to my nephrologist, and she was open to the idea, after checking if the Evusheld shots increased my antibodies count. Since most of my meetings are on Tuesdays, I was thinking of driving on Tuesdays/Thursdays to work for now.

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I received an email from work today that we are ending our indoor masking requirement. It is not good news, but one that was expected sooner than later. Since most of the coworkers in my department know my circumstances, I will still wear my KN95 masks while in my cubicle. Let us see how long I can tolerate wearing it for 8-10 hours per day.

Evusheld Shots

I received my two shots this morning. The medication is a combination of two drugs: tixagevimab and cilgavimab. I was given the injections at the St. Joseph hospital cancer infusion center. Other than getting the shots in the butt muscle, it was not any different from a vaccine shot. Maybe it is given at the cancer infusion center because the is the biggest immunocompromised population?

The nurse (male) that administered the shot was very nice and we chatted a bit. It turns out his father has been on dialysis for eight years, so he understands the issues of being an ESRD and post-transplant patient. I made sure that I was getting the new, higher dosage just approved by the FDA. They did keep me for about an hour after the shots to check for any adverse reactions, but all I have so far are slightly sore butt cheeks. The injection is only good for six-months, so they already scheduled my next appointment.

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Usually, prescription drugs come with a medication package insert with a lot of small font text. I have seen this with many of my medications, including insulin pen needles. For Evusheld, the nurse showed me the insert, and it was literally blank except for the words THIS AREA IS INTENTIONALLY LEFT BLANK. I know the medication is new and is being used under emergency approval, but there must be some information. I showed my dad and he asked, “You agreed to take shots with no information?”

Not kidding.

COVID Antibodies Test Update (updated)

My nephrologist just called me and said my results, though positive for antibodies, are relatively low compared to her other transplant patients. Typically, they are well over 150 after three or four vaccine shots, but my result was ~31. She is going to send in a referral to St. Joseph hospital cancer center to see if they will give me one of the few doses they have. Hopefully they will give me the shot since I am pretty much a regular customer, like Norm in Cheers.

You can tell how old I am by that reference.

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Updated: 2/15/2022 1:30pm

Got a call this morning from the St. Joseph hospital infusion center (did not know this was a thing). They wanted to schedule me for the Evusheld shot. That means my nephrologist was able to get one for me. Every bit helps. The appointment is in a few weeks. I will get both shots, one in each butt cheek, and they will also hold me for an hour to watch for adverse reactions. I think I will finally feel somewhat protected from COVID after these set of shots.

COVID Antibodies

Test results came back, and I have antibodies! Specifically, this is the SARS COV 2 AB (IFF) SPIKE, SEMI QN test from Quest Diagnostics.

My nephrologist already told me that the number is not indicative of the level of protection, and all the material from Quest says the same thing. However, I still take it as good news that I have some protection against COVID. I still need to take all preventative measures like before, such as wearing masks indoors and social distancing. Good to know that at least one of the four Moderna shots had some effect.

Google Timeline for January 2022

Once again, I spent most of my time at home.

I received an email from Google to review my January timeline. It was not very impressive. There were only seven dots on the map, with one missing location.

  • Home
  • Sister’s house
  • Albertsons supermarket and pharmacy
  • Tesla service center in Santa Ana
  • Pickleball courts in Tustin
  • My parents’ new house (still in escrow)
  • Chase bank
  • UCLA Health in Laguna Hills for labs

On the other hand, even with Omicron variant of COVID raging, I did not get sick. I do know that several coworkers did get COVID, but fortunately none were serious.

4th COVID Vaccine Shot

I received my 4th COVID-19 vaccine shot yesterday. After my last appointment with them, UCLA transplant clinic put a reminder in my records to schedule the booster. Since their clinics are all extremely far away, I ended up going to my local Albertsons pharmacy and got the shot there. I did call to make sure they were offering the fourth vaccine shot, but everything was fine. I even had the CDC page ready on my phone in case they asked.

Like the other three Moderna shots I have received already, I did/do not have any reactions or side-effects so far, other than a slightly sore arm. I was hoping for a bigger reaction as it may indicate the presence of antibodies.

At least the number of cases is decreasing in Orange County.

https://occovid.com/cases

The Next COVID Crisis… is Here

I just posted about this three weeks ago. At the time, I was still hoping that this next wave/spike/whatever could still be contained. No chance of that now.

https://occovid.com/cases

If you look at the previous chart for Orange County from the December 9th post, the latest “spike” was only about one-half of the case count from last year. However, that is no longer the case. The new case rate is now higher than it has ever been. I just had an appointment with my nephrologist, and she said the hospitals are getting full again, and that I should stay home for the next two weeks. Here is a chart for total US and world new cases:

https://www.nytimes.com/interactive/2021/us/covid-cases.html

https://www.nytimes.com/interactive/2021/world/covid-cases.html

1.4 million new cases for the first day of 2022. Looks like this year will not be any better than last year. In the US, with all the New Year’s Eve parties last night, the numbers will get even worse over the next few weeks.

ESRD Post-Transplant?

I guess not.

I always wondered about this. It makes sense since a kidney transplant restores almost all the functions of the original kidneys. Likely why Medicare cancels ESRD coverage three years after transplant.

I saw this paper recently: Electronic health record analysis identifies kidney disease as the leading risk factor for hospitalization in confirmed COVID-19 patients

Even though kidney transplant recipients are no longer classified as ESRD patients, this study shows that they are still as susceptible to hospitalization as those with Stage 5 ESRD. Table 4 in the paper shows:

Additional analyses using eGFR and USRDS data confirmed our findings that patients with stage 4–5 CKD, ESRD on dialysis or with kidney transplant are at extremely high risk for severe complications due to COVID-19 (Table 4).

It appears that patients with eGFR < 15 are 13x more likely to be hospitalized with COVID-19 as compared to those without ESRD. The paper suggests that “physiological stress caused by excessive inflammatory response to SARS-COV-2 infection could destabilize organs already weakened by chronic disease” or “direct organ-specific injury from SARS-CoV-2 infection could act as a second-hit to these organs.” The article also mentions “consistent with this hypothesis, kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor.”

So why is the results so high for kidney transplant patients? The n value is low at only seven cases, but the risk is about the same as Stage 5 ESRD or dialysis patients. The article does not discuss this finding, but my guess is the immunosuppressive medications weaking the patient’s immune system. That and a muted antibody response to COVID vaccines. This means even though I have a kidney transplant, the risks of COVID have not changed for me versus one-year ago while I was still on dialysis.

The Next COVID Crisis

Sigh… it seems like this pandemic will never end.

https://covid19.who.int/

This is WHO data for the entire world. There are clear spikes from December 2020, April 2021, September 2021, and right now. For the US, the data is a bit different, but cases are also going up again.

https://covid19.who.int/region/amro/country/us

Finally, data from Orange Conty. It does look like cases are picking up here too. I do not know if that is because of the Omicron variant, or just the consequence of everyone meeting up for Thanksgiving.

For me, I still have not left the house that much. Other than doctor appointments, I am still only traveling to my sister’s house, the local Albertsons, and meeting some friends for lunch last Friday. Our department is still having a holiday party at a rented house in Hermosa Beach, but I have already declined the invitation. Likewise, our church cell group is having dinner at a local Korean shabu-shabu restaurant. I think the place will be super crowded, and everyone eating out of one pot is not a good option for me at this time.

The FDA did announce approving an antibody shot for immuno-compromised people. I think I will make a new post for that.

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Oops, forgot why I was posting about this topic in the first place. I have been seeing a lot of news about continued protests regarding vaccine mandates. With more people testing positive and death rates not going down, I really cannot understand these idiots. I also read that these anti-vaxxers want to get antibody shots if they get sick. Whatever happened to not putting anything “untested” into their bodies?

Next COVID Spike?

Here is the latest cases chart from occovid.com for Orange County:

The chart only shows eight months of data, but it has the recent delta spike. From the chart, the number of new cases is steady at ~20 per 100k people per day. That does not seem like a lot, but Orange County has 3.2 million people so this represents about 640 cases per day. If we look at the entire country, there are still ~1,000 people dying of COVID daily.

I went to Panini Kabob Grill in Santa Ana to pick up dinner last night. There was a line of people outside waiting for tables, and it was mostly full inside the restaurant. Other than me and the staff, no one had a mask on, even though multiple parties were standing right next to each other in line. Do people think we are back to normal now?

Looking at the numbers from last year, I am expecting another spike for Thanksgiving/Christmas/New Year’s Day. It probably will not be as bad since the vaccine was not available last year, but 1/3 of the population are still not vaccinated. I guess we will wait and sew what happens. If the case rate remains flat, then I would feel a lot better about going back to work in-person.

Legit Booster Shot

I knew it would happen. As soon as I find a way to finally get a third vaccine shot after weeks of trying, the FDA officially authorizes a booster shot for “certain immunocompromised people” today.

People who are immunocompromised in a manner similar to those who have undergone solid organ transplantation have a reduced ability to fight infections and other diseases, and they are especially vulnerable to infections, including COVID-19. The FDA evaluated information on the use of a third dose of the Pfizer-BioNTech or Moderna Vaccines in these individuals and determined that the administration of third vaccine doses may increase protection in this population.

It is good news obviously, but I wished they moved a litter faster so we did not have to stress out over the recent delta variant surge. I believe the FDA and the CDC still needs to publish guidelines so it may be a while longer for people to get the booster shots, so I am still happy that I got mine last week.

I just checked the Digital COVID-19 Vaccine Record portal, and it has all three of my Moderna shots. I guess in the end, nobody really cared how many shots I received.

After the third shot, my arm hurt for about a day, but I did not experience any other side effects. Maybe I need to try and get a fourth shot?

3rd Moderna Shot

Yay! I got my third Moderna vaccine shot today. I did end up driving to work for the vaccination, and they did not reject me for having two previous shots. Of course, I see this on the news as soon as I get home from work:

Supposedly now the FDA and CDC are working on getting a booster shot approved for immunocompromised people. I would like to think my message to the CDC (and subsequent review) helped, but it is pretty unlikely.

Back to what happened today. As I mentioned before, I pre-registered online but did not get a rejection email so I went to our cafeteria at around 11:30 am. There was only one other person in front of me, and only about four people in the post-vaccination waiting area. The intake person followed up on some medical questions, but she did ask whether this was my first or second shot. I said second because I had to fill out the date of my “last” shot online. She then sent me to a nurse. While she was prepping my arm, she also asked about my vaccine card. Of course I did not have it, so she got out a blank card. She then asked the supervisor what to write, and also asked me where I got my first shot. When I said UCLA, they said they could look it up online. I thought you needed a PIN to access that data for individuals, but maybe they have different rights. Anyway, the supervisor sees that I already had two shots. I basically told them that my first shot was right before transplant surgery, and I was pumped full of immunosuppressive drugs right after. I also said (embellishing a little) that my doctor believes that shot was ineffective, and that I should get another shot ASAP. The supervisor looked at me in the eye, and said, “OK.” The nurse then gave me the shot, filled out the second line on the vaccine card while leaving the fist line blank, and sent me on my way. Easy peasy.

It’s been about 10 hours and no significant reaction year. My arm was okay right after the shot, but the injection area is more sore now. I also felt a bit lightheaded after climbing the stairs after dinner, but I experience that occasionally due to low blood pressure. Several people told me that the worst reaction will come tomorrow, if at all, so I am hoping I feel terrible when I wake up tomorrow. 😅