(Sorry about missing last week’s post. I’ll try to get two out this week!)
COVID parties
I guess there is a new thing called a COVID party, where people (mostly 20-30 year old’s) get together with someone who has COVID-19. The attendees apparently want to “see if the virus is real and to see if anyone gets infected.” The New York Times reported on a 30 year old who recently died after attending a COVID party.
Sometimes life is just flat out predictable.
Causes of the recent increase in cases
The current consensus is that the rise in cases in various cities and states is due to three things:
- States slow to institute quarantine and social distancing practices.
- States that opened too quickly and extensively, rather than a measured approach.
- Individuals not utilizing personal protective practices, like social distancing, face mask use, and good hand sanitation.
Remdesivir
Remdesivir is an intravenous drug for severely ill people with COVID-19. It was shown to reduce the risk of dying from COVID-19 by 30% in an original study several months ago in those with the severe form of the illness. According to a new study by the manufacturer, it works even better than previously found. Their new study (which has a good number of factors that reduce its reliability) showed a 62% reduction in death.
In spite of the study design limitations this study again confirms remdesivir is effective in treating severely ill individuals with COVID-19. This is a hospital-based treatment only, and I hope none of you need it.
Vaccines
Vaccine trials are moving along with multiple candidates on the cusp of starting phase III trials. Pfizer-BioNTech announced their virus candidate is moving to enroll 30,000 people into a phase III trial.
Phase III trials are the last major clinical step for showing safety and effectiveness in a large number of people before being approved for clinical use. Several other vaccine candidates are in similar stages of development.
I mention this for several reasons (not that the Pfizer-BioNTech vaccine is any more likely to be more effective than any of the others).
- I wanted to show the number of people needed in a phase III effort to make the study valid. This is 10’s of thousands for this phase of study for a common illness.
- Also Phase III trials are where the rubber hits the road, as they say. This is where a huge amount of effort is directed by many people, historically for 7-12 years. The clinical process gets very complicated to show benefit and safety and is typically monitored by a third party to assess safety and effectiveness.
- Occasionally a study will show such dramatic benefit and safety that the study is allowed to end prior to its planned completion date in order to be brought to market earlier than expected. That is certainly the hope with these COVID-19 vaccines.
As I have mentioned before, I am cautiously optimistic about the whole vaccine process. However I will want to know who independently reviewed the technical procedures and outcomes before accepting any manufacturer’s published results. Typically the more independent academic physicians have access to the same information as the manufacturer, the more objectively one can draw a conclusion.
Schools and the American Academy of Pediatrics position supporting school re-opening
This is another very big problem to address while trying to manage the spread of COVID-19.
One of the official task forces is reported to state that opening schools to regular attendance poses the highest risk of COVID-19 spread and online schooling the lowest risk. The evidence supporting that position was not disclosed in the article.
The American Academy of Pediatrics apparently has a different opinion and expressed a strong statement in support of opening up schools. Here is the discussion from MedPage Today. Also here is a recent article about the Return to School During COVID-19 from the AAP website.
It sounds like some hybrid program of classroom experience with 1) a reduced number of students 2) with alternating days of attendance in the classroom 3) coupled with online teaching is emerging as a possibility.
I suspect whatever plan is adopted it will be followed intensively and schools will again be shut down if there are ties of spread to school gatherings.
How to move forward on this issue does not appear to have a consensus of opinion at this time.
Check your local school district’s website for their evolving plans for the upcoming fall sessions. Each district has been tasked with making their own plan, so plans will vary by location.
Dr. Gipson
