Whither COVID-19?

Or, in modern English, where is this pandemic going? The answer is clear: we don’t know. In Shanghai 26 million people have been locked down in their homes, while in Florida the governor is imploring children to take off their masks. CDC.gov tells us that more than 982,000 Americans have died from COVID-19, more than twice as many as died in all the wars of the 20th century, but 18% of Americans more than 5 years old have not received a single dose of any COVID vaccine. And now we have an uptick in the number of cases caused by a variant that can infect even the fully vaccinated and boosted and has caused so many deaths in Hong Kong, principally in older, unvaccinated people, that the city is running out of coffins.

The CDC recently published some data that could be considered good news. CDC scientists have collected blood samples, drawn for any reason, from commercial laboratories all over the US and tested them for antibodies that signify past infection with the SARS-CoV-2 virus.  (Post-infectious antibodies can be distinguished from post-vaccination antibodies because the vaccines only contain spike proteins.) An astonishing 43% of samples (as of January 2022) were positive for past infection, including 60% of those from children. That may explain why the BA.2 variant so far has not caused as much damage here as it has in the UK and other countries.

On the therapeutic front, the news is not so good. Five days’ treatment with Paxlovid could prevent hospitalization and death from a vaccine-resistant variant (at least until the virus becomes resistant to it), but the manufacturer has not produced anywhere near as much as the inadequate amount the government ordered, and the Congress is reluctant to spend more money on COVID amid all the other demands on its largesse. Back to vaccines, scientists who should know say that a pan-corona vaccine is feasible and not far away, but if they have a more specific timetable, they are not sharing it with the public. If that became available and provided a year or even 6 months of protection, we would have the means to end the pandemic, but someone would still have to pay for it and people all over the world would need to be willing to roll up their sleeves. I hope we get a chance to see how that works out.

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  1. As this is the season of both Passover and Easter, hope is definitely a good thing. But I fear you may be a trifle overly optimistic.

  2. Nina Pierpont, MD, PhD says:

    I would be grateful if you would undertake review of early treatment protocols for Covid with re-purposed FDA-approved medications. These may be an essential part of the current and future strategy. For example, see recent legislation in New Hampshire and Tennessee increasing the availability of these medications and, indeed, telling doctors they will be compelled to instruct themselves and use them or be considered negligent. Perhaps now is a good time for review by the Medical Letter of the actual clinical and epidemiologic literature about these medications and protocols.

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