MASK and TEST to Limit COVID-19
The long-predicted Fall surge of COVID-19 is unfortunately living up to the dire warnings of infectious diseases experts. The total number of cases in the USA is up to 13.2 million, more than one million per week for the last four weeks! The total number of COVID-19 deaths recorded in our country is 266,074. Less we become numb to these numbers, we must recognize that this increase represents pain and upheaval in over 14,000 families in the last 10 days. Daily records continue to be broken as we saw 206,000 new cases yesterday and 91,635 Americans hospitalized because of this SARS-CoV-2 in the last 24 hours. Twenty-six states reported record numbers of hospitalizations this past week, ICUs are filling up, field hospitals are reopening, and worse is our brave healthcare providers are becoming overwhelmed. Fortunately, many Americans heeded CDC advice to stay home for Thanksgiving. Air travel was down 60% compared to last year, yet automobile travel was down an estimated 4%. For those who decided to travel, it is recommended that travelers and those exposed quarantine for at least 7 days then get a negative test before safely resuming COVID-19 safe activities. For Americans over the age of 65 and any individual with a co-morbidity who becomes symptomatic, be tested ASAP so that the therapeutics that have been developed can be implemented early enough to be effective. If the US sees rising cases, hospitalizations, and death numbers in the next 10-14 days then the prediction of Thanksgiving travel and Black Friday shopping being super-spreader events will be confirmed.
On the news front, the FDA granted Emergency Use Authorization (EUA) for a treatment called monoclonal antibodies. EUA is a process by which the FDA, which in the context of healthcare is responsible for giving government approval for treatments, testing, medications, and devices. The EUA is granted when the FDA deems, based on scientific documentation, that a presented item is likely to have benefits that outweigh the risks. In the case of these two monoclonal antibodies the EUA is granted for them to be administered intravenously and simultaneously. They are to be used in patients who have tested positive for the virus, have mild to moderate disease, not yet requiring oxygen treatment, and are at high risk of progressing to severe COVID-19. The long-term effects of these treatments are still being evaluated, thus the EUA as opposed to outright approval for their utilization.
On the vaccine front, the CDC is meeting this week to decide on protocols for determining the priorities for vaccine administration. The US citizenry will require over 600 million COVID-19 vaccinations, so a fair and objective sequence of vaccination needs to be established. Pfizer has requested an EUA for its vaccine. A meeting for consideration of this request is scheduled for December 10. A vaccine developed by Moderna, which also has a nearly 95% effectiveness, will be considered for EUA soon as well. Lastly, the vaccine by AstraZeneca, which is less expensive and easier to distribute around the world, is closer to viability.
In this space back in May 2020, we emphasized the importance of testing to save lives and keep our economy open. A new study from Harvard and U. Colorado details why the accuracy of a COVID-19 test is not as important as there being frequent, nearly immediate results available. One scenario detailed involved the testing of three out of four people every three days. This could be achieved by widespread testing in public places as well as home testing availability. This scenario achieved an 88% reduction in the number of people infected and enough disease detection, and resultant isolation, to “drive the epidemic toward extinction within six weeks”. The incoming Administration has widely advertised the use of the DPA to solve the testing inadequacies.
It is estimated that 100,000 lives can be saved by March 2021 if we would just MASK up! This measure represents individual responsibility for individual and public good. We need to recognize that even after vaccines become available, masking, hand washing, and social distancing will still be required because widespread vaccination will not have been completed until the latter part of 2021.
