I listened to an interview with Dr. Fauci this morning regarding some immune aspects of Covid-19.
In case anyone needs to be reminded, Dr. Anthony Fauci is a physician and immunologist who has served as the director of the National Institute of Allergy and Infectious Diseases since 1984. He has been at the forefront of the development of many vaccines including the 40 year attempt at developing one for HIV. Although our administration has access to this tireless and quite knowledgeable doctor and scientist, they are ignoring his advice. I’ll stop there because I could go off on another rant.
- Vaccine status. Despite some recent setbacks with some trials being put on hold because of some side effects, keep the bigger picture in mind. The most recent trial to be put on hold involves a US trial of a single-dose vaccine (most are 2 doses vaccines), being tested on 60,000 people. What the reaction is not known yet and in addition, we don’t even know if this patient was in the vaccine arm or placebo arm. To put this in perspective, there was one complication for every 15 individuals treated with aspirin and one death for every 556 individuals treated. There is still lots of reason to be hopeful about a vaccine. Let’s just develop one, or likely more than one, safely, not because it is politically expedient.
- Herd immunity. It may not be possible to achieve this but without a vaccine, this will most certainly be impossible. Not enough people have gotten sick or exposed. We need in the 80-90% range for this to occur and the state with the most positive cases, NY, only has 20% positivity, and only in localized areas. Most others are in low single digits. This does NOT mean that we should just open things up and let the chips fall where they may however. I had this conversation with a patient recently and when asked the question “How would you feel if your relative or child got really sick, had complications or even died?” There was silence. The risks are still low, but if it affects you or your circle of family and friends, it’s 100%. And it’s not just about minimizing deaths. As we have seen, there are many complications, some probably lasting for years if not lifetimes going forward.
- Lasting protection after infection. The simple answer is that we just don’t know. Not enough time has passed and not enough people have gotten sick. In addition, our testing capabilities stink so we don’t have the ability to monitor and test enough to tell. If infections from the Coronaviruses which cause the common cold are any indication, there may be some protection, but it wanes after 4-6 months. The same goes for the flu. We don;t have immunization against coronaviruses, or other common cold viruses like adenovirus or rhinovirus, but we do against the flu. Any protection is better than no protection.
There continues to be a lot we are learning and the longer we can keep numbers under control, the more time we have to develop therapeutics and vaccines. Stay the course. Be safe, for yourselves, but more importantly for all those around you.
DISTANCE.
WEAR A MASK.
WASH YOUR HANDS.
DON’T TOUCH YOUR FACE.
VENTILATE.
VACCINATE.
GET HEALTHY.
Stay safe and be well.
AC