Health on the Frontlines: Where We Are with COVID Today

COVID — it’s not over but hope is here. The original alpha variant, the COVID-19 virus that was first reported in Wuhan, China, has subsided and new delta variants have become the dominant strains.

The vaccines and boosters we currently have make antibodies for the original alpha variant, therefore we are seeing more breakthrough cases in vaccinated populations. Even though vaccinated people are getting infected and can infect others, vaccines continue to dramatically reduce hospitalizations and death. The reality is that vaccines put pressure on viruses to mutate as viruses want to survive and evade the antibodies created to stop them. This is why we update the influenza vaccine every year to combat the new annual emerging strains. New vaccines will be needed to combat the new emerging COVID variants. Vaccines alone cannot stop a pandemic or reduce hospitalizations and death.

The coronavirus infection has an early replication phase where it rapidly multiplies the first three to five days and then as an inflammatory phase that can cause inflammatory fluid to accumulate in the lungs and makes it hard to breathe. The amazing Regeneron COVID antibodies created in New York by George Yancopoulos MD, Ph.D and Dr. Christos Kyratsous Ph.D (both Columbia University graduates), have been amazing in stopping hospitalizations and death when given immediately within days after infection.

Other amazing oral antivirals like Molnipiravir, which blocks all variants of coronavirus, goes before the FDA on November 30, 2021 for a decision on emergency use. The U.K. has already approved it and Indian clinical trials have had great results cutting hospitalizations and deaths by 50%. The drug was invented by Dr. George Painter of Emory University and licensed by Ridgeback Therapeutics of Miami. The person who partnered with them to bring it to market and make it a reality is Dr. Nick Kartsonis; senior vice president of infectious diseases at Merck. Many scientists agree this pill will be a game changer. Taken for five days in the early phase, it will save millions of lives around the world. Like AIDS that decades later has no effective vaccines, a cocktail of oral antivirals created by Dr. Ho, currently at Columbia University, has saved millions from death and suffering. Taking a pill just as we take Tamiflu for influenza to stop COVID will change everything.

We also need better blood tests to tell us if we are immune to COVID if we have already had it. Just like we must show measles and rubella titers to enroll our children in schools and camps. The 120 million who had COVID in the U.S. one day may be able to show blood test evidence of immunity.

The pandemic is not over and as the holidays approach and people gather and travel in tight indoor spaces, we will see an uptick in cases. The good news is that therapeutic oral antiviral pills and ready-made IV and injectable antibodies will dramatically reduce death rates and hospitalizations in the next few months. With faith, hope, love, science and common sense we will get through this together. Think positive and test negative. Enjoy the visit on the planet because it’s no dress rehearsal.

Peter Michalos, MD is associate professor of Clinical Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons; Past President of Medical Staff and Past Chief of Surgery Southampton Hospital; Chairman Hamptons Health Society. He has been a resident of Southampton for three decades.