Love Thy Neighbor and Yourself. Learn the Facts, then Get the “VAX!”

Black Capped Chickadee, Ipswich River Wildlife Sanctuary

As Vice President, Clinical Integration at the Massachusetts Health & Hospital Association, I have organized and moderated weekly and biweekly Zoom COVID-19 meetings with the Chief Medical Officers (the chief doctors) of Massachusetts’ leading hospitals and physician groups throughout the past year. We have hosted some of our nation’s leading genetic, vaccine and infectious disease physicians and scientists, to update us on the evolving science of COVID-19 during these meetings. I personally delivered my first Coronavirus update to this group, over one year ago, on January 29, 2020. That day, there were only 5 known cases of this deadly pandemic in the United States. The disease had not yet even been named, “COVID-19.”

We have learned much since then, some through tragic experience. There is so much factually incorrect information out there, I am writing to share the vaccine facts with you.

In March of 2020, I wrote on DefoSays.com, that experts believed that without the development of a vaccine or successful treatment, the United States would suffer approximately 1 million deaths to this disease. Many were shocked and others could not believe it. Sadly, to date, roughly ½ million Americans have died from COVID-19. The good news is we now have two astonishingly safe and effective vaccines. Today, we can finally stop playing defense and go on the offensive against this awful disease, revive our economy and get our lives back to normal.

I encourage all of you to receive the vaccine when you are eligible. As a practicing physician, I received the vaccine when it was my turn at the hospital where I work, and I didn’t feel a thing.

If we all get vaccinated, not only will we be protecting ourselves, but we will also be protecting our loved ones and our neighbors against COVID-19 and ultimately put an end to this once in 100 years pandemic catastrophe.

Vaccine risk verses risk of COVID-19:

The COVID-19 vaccine is a critical tool to protect yourself and to end the pandemic; but you might have questions about its safety. You should know:

  • The same safety measures used for all vaccines were followed for the COVID-19 vaccine.
  • Tens of thousands participated in vaccine trials to prove they are safe.
  • Since the vaccine trials, tens of millions of people of different races and ethnicities have gotten vaccinated and only experienced mild side effects.
  • When it’s your turn, trust the facts, get the “vax.”

The serious reaction rate for the two COVID-19 vaccines available in America today is 2.5 people per million patients who received the vaccine. This is similar to the common childhood and adult vaccines we have all routinely received in the US. To put that in perspective, the death rate of COVID-19 in America is at least 10,000 dead people per million patients. COVID-19 is now the number one killer in America.

The serious reaction rate to penicillin is 100 to 500 cases per million, and we don’t think twice about taking penicillin when it will help us.

According to the data from the Centers for Disease Control, (CDC), as of 2/13/2021, 27,229,862 Americans have been proven to have contracted COVID-19 and 473,669 Americans have died from it. Most experts agree this is likely an underestimate of both the number of those infected and those who have died of COVID-19. That means for every 1 million Americans known to be infected, 17,616 have died. While it is true that in the US, a significant minority of patients with COVID-19 are asymptomatic and 80% of patients with COVID-19 symptoms experience only a mild or moderate illness, yet 20% of these people suffer severe disease requiring hospitalization and oxygen therapy.

Is it logical to let the fear of an exceedingly rare serious reaction (2.5 reactions per million, none of which were fatal) keep you from receiving a lifesaving vaccine to prevent a lethal disease? (In the US, contracting COVID-19 results in: 200,000 people hospitalized per million, 50,000 ICU admissions for respiratory failure, shock and multi-organ dysfunction/failure per million and it continues to kill 17,616 people per million.) Vaccination will also hasten heard immunity, protecting millions of others.

Vaccine Safety:

I can personally reassure you that this vaccine has undergone rigorous testing. It has proven to be a safe and effective vaccine; remarkably so. It is more effective in preventing disease than our annual flu shots.

Both of the US Food and Drug Administration (FDA) authorized vaccines are safe. Prior to FDA authorization, vaccines are required to undergo the highest level of scrutiny regarding safety, of any drug approved. This is because they are administered to otherwise healthy people, and any risk from the vaccine must be far outweighed by the potential benefit of the vaccine.

Both the Moderna and Pfizer vaccines have been held to the highest safety standards of the FDA. The mRNA technology utilized in both vaccines has been utilized in cancer treatment for years.

Mutant COVID-19 strains:

As of this date, the two vaccines authorized for use in the USA are effective against all known mutant strains of COVID-19, although their protection against the South African strain is somewhat reduced, in comparison to the other strains. But as long as the virus is circulating in humans, every single infection affords the virus an opportunity to mutate into a more deadly strain. We must end this terrible pandemic, and vaccination is the only way to do it. The latest information about the new variants can be found by visiting the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html

Vaccine side effects:

Just like any other medicine or vaccine, there is a chance that you will experience side effects after vaccination. These tend to be mild, and if you do experience them, they are proof that your body is building immunity. In fact, if you experience side effects to the vaccine, which does not contain the entire virus, just imagine what contracting COVID-19 would have been like.

The common mild side effects of the vaccine include pain at the injection site, fatigue, headache, muscle pain, chills, joint pain, swollen lymph nodes (in the vaccinated arm) nausea, vomiting, and fever. Younger people tend to experience these more commonly than older people, and more often after the second dose. If you are young, it might be prudent to schedule the vaccine the day before you have a day off, in case you have any side effects the next day. These side effects usually only last 24 hours.

Interestingly, just because someone has symptoms after vaccination does not mean the vaccination caused that side effect. People experience fevers, headaches, swollen glands or joint pain etc., all the time, and may experience this around the time of vaccination by random chance. While vaccination site pain will likely be due to the vaccination, the other common mild “side effects” noted above were also experienced by the placebo group in the trials 1/3 of the time, indicating that these common conditions are unrelated to the vaccination.

Pfizer mRNA vaccine

  • Percent of people with any symptoms: 59% after 1st dose, 70% after 2nd dose
  • Note: in placebo (no vaccine) group: 47% symptoms after 1st dose, 34% after 2nd
  • Types of symptoms: fatigue 63%, headache 55%, muscle aches 38%, chills 32%, joint pain 24%, fever 14%
  • Percent of people with moderately severe side effects: fatigue 4%, headache 2%

Moderna mRNA vaccine

  • Percent of people with any symptoms: 55% after 1st dose, 79% after 2nd dose
  • Note: in placebo (no vaccine) group: 42% symptoms after 1st dose, 37% after 2nd
  • Types of symptoms: fatigue 69%, headache 63%, muscle aches 60%, joint pain 45%, chills 43%
  • Percent of people with moderately severe side effects:
    • First dose: fatigue 1%, muscle aches 1%, joint pain <1%, headache 2%, chills <1%, fever <1%
    • Second dose: fatigue 11%, muscle aches 10%, joint pain 6%, headache 5%, chills 2%, fever 2%

In my opinion, the risk of COVID-19 hospitalization, intubation, death, and post-infectious chronic fatigue, confusion, loss of taste and smell and pain far outweigh the minimal and transient side effects of this safe vaccine.

Vaccine distribution: Health equity has been front and center in the minds of decision makers regarding treatment and prevention during the COVID-19 pandemic. We are first distributing the vaccine to those who need it the most. Priority is being given to those who are the most likely to die if they contract COVID-19, considering medical conditions, age, race, and ethnicity.

As you can see from the CDC data below, Black, Hispanic and Native Americans are roughly twice as likely to die as white Americans, and just like the frail, and elderly; these groups should be and have been prioritized to receive the vaccines first.

CDC data: COVID-19 Hospitalization and Death by Race/Ethnicity

Of course, when deciding about any medical treatment, you must look at the benefits, the risk of the alternative and make up your own mind. I only ask that you consider the potential lifesaving benefits of these vaccines for you, your family, and your neighbors when you are offered a chance to receive the COVID-19 vaccine. Vaccination is our only shot at defeating COVID-19 once and for all. I ask you to please join me in making a difference – one person at a time. Thanks.

For more information please visit the following websites:

  1. Centers for Disease Control (CDC): https://www.cdc.gov/coronavirus/2019-ncov/index.html
  2. Your own state’s Department of public health, for example, here in Massachusetts: https://www.mass.gov/covid-19-vaccine
  3. A trusted local hospital or physician practice website who share FAQs, such as; https://www.ucihealth.org/covid-19/covid-vaccine-faq
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Racism in America: We Only See What We Know

We Need More Lenses of Perspective

The story of the six blind men and the elephant is an apt analogy for the perception of race relations in America. In this ancient Indian parable, six blind men came across an elephant and tried to perceive what an elephant was, only with their hands.

  • One blind man felt the body and stated an elephant is a wall.
  • Another blind man felt the leg and insisted an elephant is a tree trunk.
  • The third blind man felt the ear and informed his friends that an elephant is a giant flapping fan. 
  • The forth blind man felt the trunk and argued an elephant is a large writhing snake.
  • The fifth blind man felt the swinging tail and concluded an elephant is a rope. 
  • The last blind man felt the rock hard tusk and argued no, an elephant is a spear. 

A wise bystander subsequently informed them all that each of them knows a truth, but only a single truth about the elephant; the entire truth can only be known, when all perspectives are heard and understood.

Prior to George Floyd’s horrible and senseless murder, I think I was in some sort of denial about the extent of racism in America. In the past, when I read about a police involved shooting where the subsequent investigation failed to result in a conviction, I was able to believe that this particular case, (and perhaps other such cases) were the result of an innocent mistaken split second judgement, not racism laid bare. George Floyd’s videotaped murder shocked the consciousness of the nation. Prior to Mr Floyd’s violent and hateful murder, I was hesitant to discuss race with my close friends of other races. Would discussing race mean admitting I see race? Of course I do, but would admitting I see race mean I was a bad person? The resultant lack of firsthand perspective limited my understanding. Since George Floyd’s murder, I have begun learning about racism from both writings and from my friends of color. I have been learning about structural racism, unconscious bias, white privilege, white supremacy, white fragility, tone policing and more.

Over the next several posts, together with my friends and colleagues, we will discuss our differing perspectives and experiences of race in America as well as offer specific prescriptions for the future. Won’t you join the conversation?

The Slow Death of Racism

by Tonya Jones (written under a pseudonym to protect her career, somewhere in America)

I am an African American female who has suffered from racism. That sentence is not surprising nor noteworthy. It would likely be remarkable if I told you I was born and raised in the United States and I had not experienced any racism. The media might have you believe that the heinous acts they now find worthy of reporting are the totality of racism’s definition. The racist acts that receive media attention which are certainly despicable and capable of daily repetition are not just the tip of the iceberg. They are merely the top slivers of ice on an iceberg large enough to sink any ocean liner.

I could tell you countless tales of actions I experienced when I worked so hard to convince myself that the action was not motivated by racism. Like the time I was 18 and the general foreman of the factory I worked at during the summer assigned me to work at a machine that required special training. The general foreman informed me the liquid I was working with was water. I later learned it was acid and by operating the machine without protective gear I could have had the acid splattered on my face as a result. Or the time I was pulled over by the police for no true reason except that I was black and leaving a predominantly white neighborhood. Or the time attorneys I worked with performed a parody of black men which they found to be amusing. These are merely examples of racism that black people experience on an all-too-frequent basis.

Every black person in America experiences the burden of racism daily. Let me state that again- every black person in America experiences the burden of racism daily. The burden may manifest itself as driving down the street and seeing a multitude of police cars when a black male is being pulled over yet only seeing one police car when the person pulled over is a white female. It may be noting the injustice when talented black peers are passed over for jobs in which they could easily excel. Racism rears its ugly head each time a black person chooses to read the news. Black people read the newspaper knowing that each racist act they read about today might have their name supplanted for the black victim du jour. I know that exemplary behavior, degrees from the most prestigious universities and professional success does not insulate me from the daily stench of racism. Racism may be experienced as feeling the ever-present need to protect your children from the same racist actions you experienced as a kid and knowing that such protection is not possible in America. While white people may read of these atrocities and sigh with despair, medical research reveals the stress black people experience because of racism raises their cortisol levels which leads to a multitude of negative health outcomes.

I find that I can only talk about racism in small doses. Yes, it tires me because I do not have a solution and I am exhausted by being expected to not only have a solution but to paradoxically refrain from talking about racism in certain settings. For me racism’s greatest challenge is that each day I experience it personally or collectively, it erodes my greatest personal asset as a human being. That asset is hope. While my hope that racism will be eliminated in my lifetime is diminishing, each time I work to call attention to its evil I realize my reserves of hope are being depleted. I will not give up because I stand on the soldiers of giants before me who suffered unspeakable pain for me. The slow death of racism will not be the victor of my last strand of hope.

Clearer Yet More Complex

by Mohamad Al-Rawi MD, MHA (written under a pseudonym as he is a Syrian refuge in asylum, somewhere in America)

Growing up in the Middle East provided me with the opportunity to look at racism and racial inequity from different angles. In Syria, and in the Middle-East in general, racism does not exist in its ‘color form,’ but as I added more years to my age, I found out that racism existed in its other forms ‘ethnic and religious’.

The dominant religion in Syria is Islam. At school, we learned early on that Islam made it clear that all humans are equal. A verse of Quran translates into: ‘‘Oh humans, we created you from a man and a woman and made you into nations and tribes so you might come to know one another. The noblest of you in the sight of god is the one who is mostly conscious about him’’. As most of the kids, I had to memorize the verse, but I did not really deeply understand what it meant. I also learned that the prophet Mohammed said: ‘‘No Arab is more favorite to a Non-Arab, and no white person is more favorite to a black person’’. In my class, I did not have kids of different color, but my best friend growing up, was a Christian young boy, Nicholas. The only thing that made me notice at the time that Nicholas was different is that he had the choice to remain in the Islamic religion class in school or to go out to play soccer while everyone else remained in class. Nicholas actually memorized the above verse and statement, among much more, as he mostly elected to remain with me in the class because we competed in getting the highest scores in all classes, and the religious class was no different. Nicholas’s situation was the first thing that opened my eyes that people could be different. This newly learned fact at the time did not really make any difference to me because my mom always taught me that some differences exist in people, but these differences do not change the fact that we are all equal; This reality sounded natural and resonated well with me.

On a macro-level, the Syrian television and governmental newspapers were full of material that spoke about the strength and unity of the different components of the Syrian nation. It also repeatedly mentioned that the United States has always wanted to destroy our nation because of our Syrian nationality, ethnicity, and religion. With the lack of transparent and accurate resources, I was not able to research the truth of what I heard on the Syrian news and my only way to verify this information and to satisfy my curiosity was to ask my mom. I realized later when I grew up that I had put my poor mom in a very difficult situation: Should she be honest with me and tell me that what I was hearing on the Syrian media was nothing but pure lies, but then risk the safety of the whole family if I made a slip and spoke to someone about it? Or should she lie to me and let me wrongly believe the Syrian regime’s lies? Just like all mothers, my mom came up with a smart third way: Wait till you get older.

As I grew older, I learned that my mom’s city, Hama, was a theater of horrific genocide that was performed by the Syrian regime in the 80s and targeted people who belonged to a certain religious group: Sunni Islam. Simultaneously as I was becoming more informed about the regime that ruled my country, bigger disapproval feelings started to develop in me towards the regime. Naturally in these situations, I started to look further into the regime’s enemy to learn more about it, therefore I started to pay more effort to learn about the United States. I found out through my careful research that the United States was more advanced than Syria almost in every important sector: economy, science, media. etc. I also learned that the US had a civil war back in the days that was ignited because of the existence of slavery at the time. I grew more and more feelings of admiration towards the US. It was clear to me that a major strength of the US was its diversity. To me, the US was a hub for people from all backgrounds, races, religions, and ethnicities. I remember my parents telling me that it was not all sweet and fuzzy as I thought and that white people in the US are still taking advantage of other people but they do it in a nicely masked way. That was something I did not really understand and was not able to verify. Then out of the blue, September 11 happened.

After 9/11, the whole world was turned upside down in the Middle -East. I started hearing more anti-Arab and anti-Muslim voices in the American media, and more anti-American voices in the Arabic media. The conflict started to get clearer but more complex to me. It was clear to me that on both sides of the world; we had a major problem of generalization and hatred, and that for the two sides to come into peace, each side might need to fix its own internal issues first. The Iraq invasion happened afterwards, and the media continued fueling the hate feelings.

I went to medical school thereafter, and I had no idea at the time that in few years the US would become my home and asylum despite, or better to say ‘regardless’ of my color, religion, or ethnicity. 

Straddling two different worlds, the “model minority” myth and striving to be “white”

by Jenny S. Chiang, MD, Medical Director, MetroWest Healthcare Alliance. Inc

I grew up in the suburbs of New Jersey in a blue and white Colonial style house with white shutters and a black front door. My parents emigrated from Taiwan in the mid-seventies with a wave of other graduate students in the sciences to attend university in places like the University of Texas at El Paso, where my parents met. From the outside, our house appeared like a quintessential American home; as a child I always thought it was the perfect shade of blue. Life within the home, however, was very much Chinese. I didn’t bother telling people that my family was from Taiwan because it was just too complicated to explain the political relationship to China. Even today I get asked if I speak Thai, when I say I’m Taiwanese. 

We spoke Mandarin at home. We took off our shoes at the door and wore slippers in the house. We ate home cooked Chinese food with chopsticks, almost exclusively. My parents read the Chinese newspaper, and I attended Chinese language school every Sunday afternoon to learn how to read and write in Chinese. My parents only hosted parties for their Chinese friends and their families. If there was something “American” I wanted to do, like go to the movies, or buy “expensive” GAP jeans, I was always reminded we are not like them (in Mandarin, of course). 

I learned quickly to straddle two different worlds. I was one of two Asian kids in elementary school and everyone would always ask if Spencer was my brother. I knew I looked different, not “American” enough, even though I was born in Syracuse, NY.  In high school, one of my closest friends, who was Vietnamese, secretly admitted she wished she had blonde hair and blue eyes. To my parents, I was becoming too “Americanized”, but to my peers, I was never really American enough– we ate with sticks and didn’t speak English at home. 

It wasn’t until later in life that I realized, it wasn’t that I wasn’t “American” enough, it was that I wasn’t quite “white” enough. But the biases were always present; racism in a subtler form. I confirmed the stereotype: I was good at math. And got straight As. I played the piano, and the violin. And I was taught to never challenge authority. I went to Johns Hopkins to study Biomedical Engineering. I went to medical school and became a doctor. But along the way, the weight of the “model minority” myth, only added to the perplexity of my own processing of race, class, and gender. 

In Asia, skin whitening products line the cosmetic counters, umbrellas are used more for shade than rain, and Asian tourists can be notoriously identified by their large wide brimmed sun hats. My cousins in Taiwan used to laugh at the idea of people lying out on a beach to get tan. Once I was asked if I had any black friends, peaking my cousins’ curiosity about stereotypes of black culture. I had little to report, as my closest black friend, Tara, was of the same socioeconomic class and very much the nerdy academic type like me. We had AP classes together and even shared the same violin stand in orchestra for four years. She was nearly perfect, captain of the basketball team, class president, and went on to Princeton. In hindsight, I don’t think she had any other choice. She too was striving to be “white” as well. 

I’ve always been proud to be an American; but also proud to be a person of color. This is not to forgive or ignore the deep wounds in our history: slavery, the Chinese Exclusion Acts, Japanese internment, Jim Crow, 9/11, and now our Black Lives Matter movement. But it is with great hope that we continue to explore what it means to be an American, and unpack the racism that is endemic across the globe.  Ironically, the times in my life when I have felt the most patriotic, have been when traveling abroad. It’s that fleeting moment of confusion when I say that I’m from the US, but the equally quick acceptance that someone like me can identify as American, that highlights the diversity of our country. 

It’s Time to Wake up White America, Before We Close our Eyes Forever

by Steven M. Defossez, MD, EMHL, CPE, Principal, DefoSays Consulting, LLC

When I grew up in 1960s, I was taught by my parents that racism was evil and that racism was a hatred of a person due to the color of their skin. Racists disliked those who were somehow “different” and some racists hurt and even killed those who did not look or think as they did.  Nazis and KKK members were clear-cut racists. They were evil.  One difficulty in addressing race is that we know “racism” is evil. Yet we are not evil.  Therefore we are reluctant to recognize, admit or even consider our own roles in the slow, relentless operation of the gears of “systemic racism,” and our own unconscious biases.

I was taught that racists were not only bad people, but they were lacking in imagination, for if they ever thought about how they ended up with their own skin color; they would be forced to conclude that they had nothing to do with it. If their parents were of any other race, they would have been born into that race.  In fact, if their parents had been rattlesnakes, they would have been born a rattlesnake.  We can claim no pride of accomplishment for what body we were born into. God (fate, destiny or karma) made that choice for us. Paraphrasing Mahatma Gandhi; unless we are prepared to call all men and women our brothers and sisters, we have no right to call God our father.

My grandparents were all immigrants (from Greece and Belgium) who had to learn English as a second language.  In 1919, my grandfather arrived in America from Greece with $35 dollars in his pocket and a job offer to work in a distant copper mine in Utah. Upon arrival at Ellis Island, his name was shortened from Markos Maroupakis to Markos Maropis.  Maroupakis was apparently too hard for Americans to pronounce. 

Years later, Grandpa Markos was so proud that both he and his wife had become US citizens. He never missed an opportunity to vote. In fact, he dressed up in a suit and tie to vote, much to the chagrin of his wife and daughter who teased him mercilessly for this. Grandpa Markos taught me that I didn’t have to sing God Bless America, because God already had blessed America.

America had allowed my grandfather to choose his occupations (a copper mine laborer, and a builder of railroads, a waiter at Princeton University and ultimately, a licensed barber in Manhattan). For this he was always grateful until his death at age 89. I was taught that America was the land of opportunity, America was a great melting pot, from which immigrants from all over the world came to become Americans. E pluribus Unum; out of many, one. Yet America had original sin.

In school we were taught that America had a tortured history filled with territorial expansion at the expense of indigenous people, slavery, Jim Crow, poll taxes and active segregationists. But we also had heroes like Rosa Parks and Martin Luther King Jr. The times were a changing in the 1960s and black Americans were beginning to achieve the civil rights denied to them for far too long.

I urge you to read (or reread) Dr, Martin Luther King Junior’s Letter from a Birmingham Jail. This letter is incredible in its moral clarity, brilliance and poetic eloquence. It is as apropos today as it was in April of 1963.

I also highly recommend a real eye-opening, perspective-enpanding book, Me and White Supremacy: Combat Racism, Change the World, and Become a Good Ancestor . I don’t think any white person can be the same person after reading it.

As a white friend and colleague of mine recently remarked, after listening to the heart-rending experiences of a black woman growing up in America, “It stuns me how little I really know about the suffering of others.” As a first step, let’s try to truly listen to one another.

We will share more in the months to come, in the meantime, be well and stay safe my friends.

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