A lot has happened in the fight against COVID-19 in the past almost-year. In fact, doctors say the efforts have been especially impressive given that we had never even heard of the novel coronavirus at this time last year.
“It’s absolutely incredible,” Dr. John Sellick, an infectious disease expert and professor of medicine at the University at Buffalo/SUNY, tells Yahoo Life. “April, when the pandemic really hit the U.S., seems like it was back in my childhood.”
Dr. Rajeev Fernando, an infectious disease specialist working in COVID-19 field hospitals across the country, agrees. “Science has taken a great leap,” he says. “I’m very happy with how things have progressed in the fight against COVID-19, and where we’re headed.”
But given all the developments in the fight against the virus, it can be tough to sort out what’s ahead. “There’s been so much, I have trouble keeping track of everything we’ve done,” Sellick says. Sound familiar? Here’s what you need to know about the battle against COVID-19 heading into 2021.
As of right now, researchers are testing 63 vaccines in clinical trials on humans, according to The New York Times’ coronavirus vaccine tracker. Only two vaccines — one created by Pfizer-BioNTech, the other by Moderna — have been granted emergency use authorization (EUA) by the Food and Drug Administration.
How the vaccines work
Both vaccines use a newer technology called messenger RNA (mRNA). While mRNA wasn’t invented to fight COVID-19 — it has previously been used in vaccine candidates for influenza, Zika, rabies and cytomegalovirus (CMV), per the Centers for Disease Control and Prevention (CDC) — these are the first authorized vaccines that use the technology.
The mRNA vaccines work by encoding a portion of the spike protein found on the surface of SARS-CoV-2, the virus that causes COVID-19. The vaccines use the encoded protein to create an immune response in your body, and antibodies are developed. Those antibodies will help your body fight off future COVID-19 infections.
Once your body is done using the mRNA’s “instructions” to combat COVID-19, your body breaks it down and gets rid of it, the CDC explains. The CDC stresses that mRNA vaccines do not use the live virus that causes COVID-19, so you can’t get the coronavirus from the vaccine. They also do not affect or interact with your DNA. The technology “is a game changer,” Fernando says, adding, “it’s likely that many more companies will start using this technology.”
Who will get vaccinated first
Supplies of the vaccines are limited and, as a result, initial doses are allocated to healthcare personnel and residents of longterm care facilities, per the CDC. That guidance is based on recommendations from the Advisory Committee on Immunization Practices (ACIP).
As of now, the CDC has only released guidance for the first phase of vaccination. That includes:
· Phase 1a: Healthcare personnel and long-term care facility residents; this is happening now.
· Phase 1b: Essential workers, including teachers, police officers, firefighters, utility workers, corrections officers and transportation employees are in this phase. Adults age 75 and up are also in this group.
· Phase 1c: Older adults age 65 to 74, and adults with underlying conditions that put them at high risk for a severe case of COVID-19 or death from the virus.
The CDC has not revealed approved plans for distribution of the vaccine beyond phase one. However, the National Academies of Sciences, Engineering and Medicine released framework in October that has not been approved that breaks down suggestions for the remaining phases:
· Phase 3: Young adults, children and workers in industries like as colleges and universities, hotels, banks, exercise facilities and factories are in this group because they have a “moderately high risk of exposure,” the National Academies of Sciences, Engineering and Medicine says.
· Phase 4: Everyone else who has not had access to the vaccine
It’s hard to say exactly when the general public will have access to the vaccine, but there should be enough doses to vaccinate the entire U.S. population by June, Moncef Slaoui, chief science advisor for Operation Warp Speed, told The Washington Post in early December.
“By the middle of the year, I hope most Americans will have been immunized, which means the level of hesitancy that exists currently will have been decreased because people will have learned more information … about the vaccine,” he said. Slaoui also said he anticipates that the U.S. “should have this pandemic under control in the second half of 2021” if enough people get vaccinated.
The U.S. — and the world — has cycled through many different potential treatments for COVID-19. But, as of the now, the FDA has approved just one drug, remdesivir (Veklury), to treat COVID-19.
Hospitalized patients with severe COVID-19 may also receive dexamethasone, a steroid medication, if their body’s immune system overreacts to the threat of the virus, the CDC says. This overreaction can cause damage to the body’s organs and tissues — dexamethasone helps tamp down on it, Sellick says. Dexamethasone is also recommended for patients who need supplemental oxygen, per the CDC.
The dexamethasone-remdesivir combination has been used for months now, but remdesivir is “kind of falling out of favor,” Fernando says. In fact, the World Health Organization (WHO) issued a statement in late November recommending against the use of the drug to treat COVID-19. “There is currently no evidence that remdesivir improves survival and other outcomes in these patients,” the WHO said in the statement.
However, remdesivir has been found to shorten a patient’s hospital stay by a day or two. “Normally, we wouldn’t get too excited about that, but now with the way our hospitals are packed to the gills, if we can get people out a day or two sooner, that is critical,” Sellick says.
The FDA has also issued EUAs for two investigational monoclonal antibodies to treat patients at a high risk of disease progression and severe illness from COVID-19. The monoclonal antibodies work by attaching to parts of the virus and can help the immune system recognize and respond more effectively to the virus, the CDC explains. Those drugs include bamlanivimab and casirivimab plus imdevimab. While preliminary data suggest that some people who aren’t hospitalized may benefit from receiving these monoclonal antibodies early on after they’ve been infected, the National Institutes of Health’s COVID-19 Treatment Guidelines says there is “insufficient data” from clinical trials to recommend for or against these treatments for outpatients.
“Most places have tried to ramp up the use of monoclonal antibodies,” Sellick says. But, he adds, “the problem is that they need to be given intravenously and trying to bring someone with COVID-19 in and give them an IV infusion safely can be a challenge.”
For people who have the virus but don’t have a case that is severe enough to be hospitalized, the CDC recommends doing the following: Taking medications, like acetaminophen or ibuprofen, to reduce fever; drinking water or receiving IV fluids to stay hydrated; getting plenty of rest to help the body fight the virus.
“We’re all looking for the magic bullet treatment for COVID-19, but it’s not the way science works for the most part,” Sellick says. “We’re just not at the point with COVID-19 treatment where we are with giving antibiotics to treat bacterial infections.”
Experts say it’s hard to predict for sure when things will reopen. However, there are a few clues. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told NBC 4 New York that it largely depends “on the uptake of vaccines” by people.
"We've got to make sure that people get vaccinated,” he says. “So if 75 to 85 percent of the people in the country get vaccinated as the vaccine becomes available, and the general public — not speaking of the people of the highest priority who have underlying conditions — young men and women… If they get vaccinated through April, May and June, and really do a full-court press to get everybody vaccinated, you can get back to normal or at least approaching close to normal, as you get into the late summer and early fall.”
Fauci also said in an Instagram interview with Jennifer Garner in September that he expects Broadway to reopen by the fall. “I would think by the time we get to the end of 2021, maybe even the middle of 2021, if we get a vaccine that’s a knockout vaccine that’s 85 to 90 percent effective and just about everyone gets vaccinated, you’ll have a degree of immunity in a general community that I think you could walk into a theatre without a mask and feel like it’s comfortable that you’re not going to be at risk,” Fauci said.
Currently, the U.S.-Canada land border is closed to travelers until at least January 21. The border was closed in March to help slow the spread of COVID-19 and it has been renewed each month since then.
Some countries in Europe have currently banned travelers from the U.K. after a new strain of COVID-19 was detected across the country’s southern region. The Netherlands has banned flights through at least the end of 2020, while Belgium has issued a flight and train ban, per the Associated Press. Italy also suspended air travel and Germany is creating regulations, The New York Times says.
Overall, experts are hopeful things will return to normal by the summer or fall. “Things will start to get back to normal or towards normal by the end of summer,” Fernando says. However, he adds, “this virus has changed us forever. It’s hard to say what ‘normal’ will be after this.”
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