With cases in the US surging, on November 12, 2020, the director of the National Institute of Allergy and Infectious Diseases, Dr Fauci, announced that “The Cavalry is Coming” …
but in the meantime, adherence to standard public health procedures is critical he said. This recommendation is to avoid further spikes in COVID-19 cases due to the upcoming festive season, starting with Thanksgiving this week.
“The cavalry is coming” statement by Dr Fauci is in response to announcements of efficacious vaccines from major Pharmaceutical companies. The first announcement came from Pfizer/BioNTech on November 10, stating that its mRNA-based vaccine was 90% effective without any major side effects. This was quickly bested by the Russian health ministry, which announced that its more traditional adenovirus-based vaccine was 92.5% effective. A few days later Moderna announced that its mRNA-based vaccine is 94.5% effective. Interestingly, following subsequent re-analyses both the Pfizer/BioNTech and the Russian health ministry, indicated that their vaccines are 95% effective. Further, a number of candidate vaccines from China are very promising, and the Oxford-AstraZeneca viral vector vaccine has been found to have an average effectiveness of 70% (and up to 90% effective when administered as an initial ½ dose followed by a full dose). This is definitely much needed great news, and a time for optimism.
Pfizer/BioNTech have already applied for emergency use authorization to the US FDA, and it is anticipated that Moderna will do the same in the coming days. Others are expected to apply for approval at their local regulatory constituents. Despite requiring storage at low temperatures, -80oC (Pfizer/BioNTech) and -20oC (Moderna), distribution of the mRNA-based vaccines is anticipated to begin before the end of the year! Distribution of effective vaccines could be possibly be the endgame for the COVID-19 pandemic; but there are still many hurdles in reaching the 70% population target required for herd immunity. Also, it will depend on the length of immunity afforded by each vaccine, and it doesn’t take into account any potential nasty mutational twists.
In other exciting developments Eli Lilly’s neutralizing antibody bamlanivimab, and Regeneron’s casirivimab and imdevimab antibody cocktail, have been granted emergency use authorization for the treatment of COVID-19. Distribution and availability of these neutralizing antibodies Is not clear; an initial 300,000 dose allocation will be distributed to high risk individuals by the US government, and the number of 1 million doses by the end of the year is the most discussed at this point.
Despite these exciting developments, at this time, the main treatment for people with sever COVID-19 is supportive care, with the broad-spectrum anti-inflammatory, dexamethasone, and blood thinning medications used as necessary; although approved, remdesivir remains controversial, with the World Health Organization recently calling its effectiveness into question.
As Dr Fauci said, “The cavalry is coming”, but for now public health measures – hand washing, mask wearing, and social distancing, are critical especially during the festive season!
Until next time … Tranquilo Polymaths.