Out of Control

On Sunday White House chief of staff Mark Meadows appeared on CNN’s “State of the Union.” Meadows was roundly criticized for saying that the U.S. would be unable to “control” the coronavirus pandemic until we develop more new therapeutic options and have one or more vaccines available to the general public. The MSM pounces on every utterance from the Trump administration and in this case they went ballistic over Meadow’s statement “unable to control.” Every action taken by the President was harshly criticized, including the travel ban from infection zones in China & Europe. Biden and other Dems labeled the actions racist and xenophobic yet now Biden says he would have handled the pandemic better. Recent weeks have seen a rise in the number of infections in many states, a fact that some authorities attribute to more family gatherings. In some regions, however, this is placing a strain on hospitals where ICU units are at or near capacity. The distribution of the virus has shifted to a less vulnerable portion of the population, young adults. Many of those infected in this group have few, if any symptoms. Individuals who don’t know they are infected will not self-isolate and could become “super-spreaders.” In that type of situation the only way to contain a disease is to test everyone. The problem with testing everyone is that you will always have a certain number of false positives and false negatives. In these instances individuals won’t self-isolate and spread of the virus is much more likely. Medical experts are not recommending lockdowns as a means of “controlling” the virus, and in fact they can be counterproductive. The coronavirus will not go away and the only way to control it is to learn to “live with” the virus, much as we have lived with the influenza virus. Most of those being diagnosed (75-85%) with COVID-19 in the past month have reported wearing masks all of the time or most of the time. That suggests that we can’t rely on masks alone to protect us from viruses in general and COVID-19 in particular.

The U.S. currently has 4 COVID-19 vaccines in Phase 3 trials. Two have been placed on temporary holds pending investigation of patient complications. The two vaccines on hold are the Johnson & Johnson vaccine that employs an adenovirus vector and the AstraZeneca/Oxfam vaccine that also employs a viral vector. The other two vaccines that are closest to approval are the Pfizer & BioNTech vaccine and the Moderna vaccine. Both vaccines have proven to elicit a T-cell response as well as neutralizing antibodies. T-cells are long-lived immune cells and vaccines that activate T-cell activity would likely provide longer-lasting immunity than other vaccines. Even if vaccines are given FDA approval for Emergency Use Authorization (EUA) long term studies will continue to determine how long immunity lasts and whether a “booster” will be necessary. We will also need to determine if the virus mutates and whether that will necessitate a yearly vaccine similar to influenza. Once EUA has been granted by the FDA administration of the first doses will be made to healthcare workers, first responders and high-risk individuals. When the FDA approves the vaccine for general use and more doses are available, the vaccine will be dispersed to clinics and pharmacies in a coordinated fashion. The Trump administration deserves some credit, not criticism for its handling of the coronavirus. A Biden administration would have done no better and likely much worse.

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