I have good news to report from the COVID-19 frontline; there is finally light at the end of the tunnel. Before getting to the good news, let me first disclose the bad news. The next few months will see a record number of American COVID cases and, sadly, deaths. As predicted, the Thanksgiving holiday served as a national super-spreading event, and cases are still peaking around Christmas. Due to the Christmas and New Year holidays and associated travel, we will also see a second winter surge of cases that will peak at the beginning of February. The next eight to 12 weeks will be some of the darkest months in American public health history; to put that in context, we will be within striking distance of the number of deaths from the last public health catastrophe, the Great Influenza Pandemic of 1918, a time when viruses were unknown. Put another way, despite our extensive knowledge of COVID-19, including how it transmits, how to prevent transmission, how to treat it using ventilators and steroids; we may surpass the number of U.S. deaths from the Great Influenza Pandemic of 1918!
Before I get to the good news, let me explain what these next few months will look like practically. In Louisiana, we may likely continue to stay in Phase 2 or possibly some Phase 1 with Phase 2 for a modified Phase 1 and 2. The ultimate outcome is that bars and entertainment/music venues will probably remain closed. The music scene in New Orleans (and surrounding areas) will remain paralyzed.
OK, now for the good news. There is a light at the end of the COVID tunnel, and that light comes as vaccines. The sooner we all get vaccinated for the coronavirus, the sooner we get back to being a music town once again. The more of us who get vaccinated, the sooner we get back to being a music town once again. In fact, the COVID vaccine is the best shot that we have to play live music again.
By now, clearly, you have heard of the term herd immunity? This means that once a certain number of people in a community have become immunized to a pathogen (let’s use COVID as an example), the less likely it is for this pathogen to circulate and cause infections. So, with COVID, if 70-75% of the population were to get vaccinated, herd immunity is achieved, and the virus could not sustain itself among the rest of the 25-30% of the unvaccinated population. When that occurs, the pandemic is over.
Are the vaccines safe, and how do they work? In short, yes, the vaccines are safe, and I will explain why after I explain how they work. The vaccines made by Pfizer and Moderna are called mRNA (messenger RNA) vaccines. mRNA is a piece of genetic code, wrapped in a fatty envelope (I will get back to this later) injected into your bicep and ultimately into your muscle cells. mRNA is the set of instructions encoded by our DNA so that proteins (the building blocks of everything in the human body) are made. Every cell has its own DNA—the DNA gets copied into mRNA, and it transports this to the cell’s version of a 3D printer—the ribosome. The mRNA code is delivered to the ribosome which then starts to “print” proteins. In the COVID vaccine, the mRNA is encoded to “print” the spike protein from the virus.
Let me state clearly that the mRNA vaccines’ point is to use your body’s own cellular machinery to produce the spike protein from the coronavirus. That spike protein is better known as an antigen. This is what your immune system recognizes and responds to by building up an army of antibodies that will remain active in the event you are exposed to the actual coronavirus. Your immune system will recognize the spike protein from the virus, send the pre-established antibodies to neutralize the virus, and voila! Infection prevented (95% of the time).
Here is another way to think of the vaccine using a music analogy. Let’s say that the DNA equivalent is a sheet of music. The notes on the sheet of music are like genes (DNA), and when those notes are played in a certain order, in a certain tempo, in a certain rhythm, the final result is a song. So, if the sheet of music is the mRNA, the musician is the ribosome. The musician takes that code (the sheet of music) and translates it into music by reading the code and interpreting its meaning. The final product is a song; in this analogy, this is the spike protein.
The safety data is emerging from these vaccines, and unsurprisingly they are noted to be safe. Why unsurprisingly? Well, mostly, you can think of these vaccines as being organic to a sort. The vaccine itself is a piece of genetic code (mRNA) that is immediately incorporated into the muscle cells that the vaccine was injected into. The mRNA code is fed into the “3D printer” (and in doing so, it dismantles the mRNA), and the body uses its own ingredients to make the antigen (the spike protein). That spike protein stimulates the immune system, which creates antibodies, and this entire process is organic and is safe. There will be some soreness in the arm and possibly a flu-like illness after the injection, which is because of that fatty envelope used to deliver the piece of mRNA. This is a normal process and should not be seen as a complication of the vaccine.
HAMP Fest: musicians get tested on-stage at One Eyed Jacks.
So, here is my ask from the New Orleans musician community: Please get vaccinated once you can. Please photograph yourself being vaccinated and publish on your social media channels. The image of New Orleans musicians being vaccinated will be tremendously instrumental in influencing others to do the same. For the past 10 years, I have been hosting the HIV Awareness Music Project (HAMP Fest), where I would have NOLA musicians get mock-tested for HIV live on stage to show how easy it is to test for HIV. I cannot underestimate the influence of having musicians model positive public health behaviors. Your influence is powerful; your fans will follow your lead.
Please get vaccinated for COVID-19 and encourage those that follow you on social media to do the same. The sooner that we can get to 70-75% herd immunity, the sooner that bars and clubs will open to patrons that would like to see live music again. The COVID vaccine is the best shot that we have to play live music again.
Dr. MarkAlain Dery, epidemiologist and musician
MarkAlain Déry, DO, MPH, FACOI, is the Chief Innovation Officer and Medical Director of Infectious Diseases at Access Health Louisiana, the largest Medicaid providing clinic system in Louisiana. He is a practicing infectious diseases physician, epidemiologist, and hosts a daily 10-minute podcast called COVID NoiseFilter, which looks at COVID-19 news through the filter of social, economic, and racial justice. Before COVID-19, he was the bandleader and bass player for a rockabilly trio with steady weekly gigs.
