5 must-haves to achieve independence from Covid-19

Far from being cause for celebration, this 4e of July marks the 6e wave of Covid-19, with Variants BA.4 and BA.5 leading the parade. As one variant of concern follows another, the world remains in a state of disarray as distraught researchers and governments hunt the virus in a seemingly endless game of whack-a-mole. Each new variant of concern is either more easily transmissible (as with BA.4 and BA.5), better able to evade acquired immune protection from acute infection or prior vaccination, and/or more virulent.

June 28e FDA meeting Vaccines and Related Biologicals Advisory Committee, VRBPAC meeting was emblematic of the disarray of the system. The task of the panel was to decide whether to approve a new booster (hopefully available by this fall) to provide protection against the latest variants of concern. The group recommended recall by a margin of 19 to 2 based on data demonstrating no reduction in BA.4/BA.5 transmissibility, let alone protection against it.

Acting President, Dr. Arnold Monto argued that this action was necessary because Covid-19 is “a virus that does not follow the rules.” Dr Monto seems to ignore the fact that the virus is follow the rules – his own. Such thinking marries pride in the continuation of our past, anemic at best, response to the pandemic (which has been reactive rather than proactive) with denial that other strategies must be developed if we hope to outrun the pandemic. pandemic.

Over the past 30 months, our incomplete understanding of how the SARS-CoV-2 virus works as well as the many weaknesses in our health response to the pandemic have become apparent. While the past cannot be changed, it is possible to recognize what went wrong, refocus, and take action to correct multiple disconnects if we are to reverse direction toward a healthier future.

Here are 5 problems we need to solve if we want to get out of this dangerous and downward road:

1. Our understanding of Covid-19 is still rudimentary

Beyond the deaths of so many innocent people, the continued dearth of basic scientific information about the disease (as evidenced by Dr. Monto’s statement about our understanding of the behavior of the virus) is still alarming. Today, too few researchers and even fewer clinicians can stand up and give serious talk about what happens when viral infection begins and precisely how SARS-CoV2 damage is caused in the body. It should be obvious by now that Covid-19 is not a respiratory disease, and we better recognize it as soon as possible. Of course, the damage occurs in the airways and lungs, but also widely in the blood vessels, with one of the main harmful effects of the virus now known to be the activation of the complement system, specifically driven by early hyper-activation of the lectin pathwayan important part of innate immunity.

Ultimately, it comes down to this – it’s not just about sparing us from ineffective therapeutics based on scientifically inaccurate ideas, it’s about dangerous therapies that slow down and can even prevent the adoption of medical protocols efficient. Just to reinforce this principle, here are some additional questions that would be wonderful to answer: What other damage is Covid doing to our bodies and how can we fix it? Once we have “overcome” Covid-19, what is the prognosis?

2. Vaccinations against Covid-19 are becoming problematic in so many ways that we need to rethink their use.

SARS-CoV-2 is not the flu, but the success of the Covid-19 vaccine is measured using statistical flu vaccine modeling. It’s little more than confirmation bias that reinforces preconceptions that Covid-19 is just another flu and, as expected, yields disappointing results. Immune protection, whether from acute infection or vaccination, wanes. With this decrease in protection, we become increasingly vulnerable to infections, reinfections, serious infections requiring hospitalization, and death. As well-meaning as they are, VRBPAC members, in an attempt to do something about it, endorsed the modification of a vaccine designed to protect against a viral strain that is barely circulating. Voting to extend the approval of new vaccines is tantamount to advocating for the administration of the 2019 flu vaccine for the 2022 flu season.

3. Covid-19 is staying with us longer than we think and what is it doing?

I recently spoke with Dr Ami Bhatta renowned Stanford University hematologist, who leads a team focused on viral fragments of Covid-19 that persist in the gut and which was recently reported in Nature. She and her team have been studying Covid-19 patients for over a year. She became interested because, despite reports at the time that much of the virus focused on respiratory problems, many patients also reported vomiting and diarrhea. She published results last month showing that viral fragments persist in the gut for months after infection.

A few people, she found, excreted viral RNA in their stool for up to seven months after a mild or moderate infection. Although the data in her study focused on infections during the first wave of the virus, the Omicron variant(s) raises critical questions, she believes. Dr. Bhatt plans to collect comprehensive longitudinal data on patient symptoms to see if new variants are more effective at infecting the gut. She intends to study whether gastrointestinal symptoms with Covid-19 play a role in the development of Long Covid. Underlying his work is understanding what role, if any, a person’s microbiome might play in terms of Covid infection and outcome.

4. Our healthcare system is fragile and the continued stress of Covid-19 will accelerate exposure to critical weakness

A rush to formulate and distribute vaccines at the start of the pandemic was an understandable effort to prevent our health care system from being overwhelmed. Operation Warp Speed ​​was launched in the belief that this pandemic would be both short-lived and manageable if we could stop transmission. Although well-intentioned, the basic premise was flawed because it was based on seasonal flu models. SARS-CoV-2 is neither flu-like nor seasonal.

Covid-19 hasn’t created a nationwide shortage of healthcare workers or overburdened hospital systems, but it has accelerated problems. We now have health care providers to the point of burnout and hospital systems taxed to breaking points. Without considerable reform and support, this status is unsustainable.

5. A declining global economy, a declining will to fight Covid-19 and all this as we enter a new wave of the pandemic

We are now in the second half of 2022 and here in the United States, President Biden has yet to secure new large-scale funding commitments from Congress to continue our fight against Covid-19. Even basic research on Covid-19 and investments in much-needed medicines have become scarce. Elected officials here and elsewhere no longer want to discuss the pandemic, let alone devote money to it. The public and even the media are exhausted thinking about it.

Still, if you look at infection and reinfection rates, it’s much more reasonable to say that we’re only halfway through the pandemic. And all this while global conflicts, inflationary pressures, supply chain disruptions, societal polarization and general psychological distress have taken their toll. This should make us think.

We need to change this parade route

As we should understand by now, Covid-19 is a problem that cannot be dealt with piece by piece or discontinuously. This is not a problem that can be dealt with by one country alone. This pandemic is and always will be a global problem that requires global efforts to be solved. If together we remember these points, then in the future we can expect a healthier and happier life.e July holidays.

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