I am worried. Public health authorities, infectious disease experts, drug companies and government officials have put all their eggs in the vaccine basket. Billions are being spent to get people vaccinated. It seemed like the best plan. But new variants are on the loose. Why haven’t we invested equally in antiviral medications and other kinds of immune boosters?
How Dangerous Are the New Variants?
B.1.1.7:
There are three worrisome variants of SARS-CoV-2 circulating in the US. Most prominent is B.1.1.7, originally identified in the UK. It has been found in all 50 states and has infected at least 15,000 citizens. This version of the virus is more contagious and more lethal than the original.
P.1:
Then there is the P.1 Brazilian variant. It is widespread in Massachusetts, especially on Cape Cod. Like B.1.1.7, it is also more easily transmitted than the original coronavirus. COVID researchers around the world have focused on Brazil and the city of Manaus because of the variant labeled P.1.
Manaus was hit very hard a year ago. By April and May of 2020, it looked as if herd immunity might have taken hold. Cases were dropping fast, and people were breathing a sigh of relief. But in February, 2021, cases took off again. A large number of people who had been infected with the original SARS-CoV-2 virus were being re-infected with the P.1 variant.
People who are infected with the original COVID-19 virus make antibodies that should protect them from re-infection. But P.1 somehow seems able to bypass the body’s protective natural immunity. It appears to be both more infectious and more deadly than the original coronavirus. The hospitals and morgues in Manaus have been blitzed.
Double Mutant:
Then there is the double mutant variant. It is driving a devastating surge in India and has also been seen in California. Two different mutations enable the virus to attach to cells more readily. Experts hope that the vaccines currently in use will continue to work against all three variants.
Good News on the Vaccine Front:
Vaccination rates have been climbing in many places, and cases, hospitalizations and deaths have been falling. When the US was at its peak on Jan. 8, 2021, there were 259,571 reported cases. Yesterday, according to The New York Times case count, there were “only” 64,409 new cases reported.
There were 2,369 deaths on March 3rd, down 8% over the last two weeks. There were 45,462 people in hospitals. That is down an impressive 29% over the last 14 days. Seems like good news, right? The trouble is, the downward slope has been leveling off over the last week. Let’s hope it’s a momentary blip on the radar scope and the trend continues downward.
Although people would like for the vaccination push to spell the end of the pandemic, public health experts warn us to continue using caution. Dr. Rochelle Walensky is the head of the CDC.
She addressed the problem head on last month:
“Please hear me clearly—at this level of cases with variants spreading, we stand to completely lose the hard-earned ground we have gained. These variants are a very real threat to our people and our progress.”
Vaccines vs. the New Variants:
The most pressing question is: Will the available vaccines protect against new variants like P.1? A few weeks ago, we had no idea.
Public health authorities have been banking on the vaccines to create herd immunity. The assumption has been that once enough people are vaccinated, the virus won’t be able to spread. The new variants are throwing that hope into question.
We know from both Brazil and South Africa that people who have been infected with SARS-CoV-2 can become re-infected with the new variants. That’s not good.
I keep reading reassuring messages from public health officials that even if the vaccines aren’t as effective against the new variants, they will protect against hospitalizations and deaths. I sincerely hope that is true. But there were not enough people in Manaus, Brazil, who had been vaccinated to evaluate that claim.
According to an article in The New York Times (March, 3, 2021):
“The country is currently using the Chinese-made CoronaVac — which laboratory tests suggest is less effective against P.1 than against other variants — and the one made by the British-Swedish pharmaceutical company AstraZeneca.”
What About Other Vaccines?
A report published in The New England Journal of Medicine has allayed some fears (March 8, 2021). According to the manufacturers, the Pfizer/BioNTech vaccine is effective against P.1 in laboratory tests. The researchers used serum from vaccinated volunteers and found that it neutralized the virus.
Will We Need Booster Shots?
As new variants of the coronavirus continue to evolve, we are told that drug companies can quickly create modified vaccines. That IS good news, though we suspect it will take several months for each new booster to become available.
If existing vaccines prevent people from getting seriously ill and keep them out of the hospital, there should be enough time to develop effective booster shots. In some respects, though, this seems too much like “Whack-a-Mole” for my taste.
What About Effective Antiviral Medications?
I have one major disappointment about how the virologists, infectious disease experts, public health authorities and drug companies have responded to COVID-19. The focus of attention has seemingly been directed primarily towards vaccine development. Don’t get me wrong. I am all for effective vaccines. I have been as impressed as everyone else at how fast the companies have created very effective shots. The billions that have been invested have paid off.
But I would have hoped that the powers that be were equally invested in developing highly effective treatments. We need powerful oral antiviral drugs that can be given at the first sign of disease. And we need them to be safe.
Joe’s Dream:
Here’s what I would like to see. First, we need rapid COVID tests that are as reliable as pregnancy tests. Every household in the country should have access to such tests. They should provide easy-to-interpret, accurate results within 10-15 minutes.
As soon as COVID is detected, pills should be widely available in every pharmacy in the country. They should be able to snuff out COVID-19 before the virus does damage or becomes infectious. If people are treated early with medications that cure the virus and prevent spread, we would be on our way to true recovery.
We know of one drug under development that might be promising. It has been called EIDD-2801, MK-4482 or molnupiravir. You can listen to Dr. Ralph Baric (the Coronavirus Hunter) describe it on our podcast.
Older drugs that are already available, such as fluvoxamine, should be tested with the same resources and enthusiasm that were directed towards vaccine discovery.
