Hope is Healthy
MEDICAL AND MENTAL HEALTH UPDATE
We got a WHOPPING DOSE of hope this weekend. After months of trauma, uncertainty, and stress, it’s just what the doctor ordered.
Since March, our mental health has been in crisis. Science has been sidelined, medical experts silenced, and facts spun into spider webs of mistruths at the expense of American lives and public trust.
We’ve been craving steady leadership to control the virus and heal our nation’s wounds. We needed this spoonful of sanity and have gladly gulped it down. To celebrate, my daughter climbed on our roof.
Hallelujah!
There must be something in the air. Because two hopeful developments have just emerged toward taming the coronavirus beast.
First, Pfizer today announced preliminary data suggesting that its vaccine is highly effective at preventing COVID-19. While we still don’t know about its long-term safety or the durability of immune protection, the efficacy data is promising. Pfizer will apply for an EUA (Emergency Use Authorization) from the FDA later this month. This is HUGE!
And second, the New England Journal of Medicine just published encouraging data on the efficacy and safety of monoclonal antibodies. (To remind: these are laboratory-produced proteins that are clones of the antibodies from recovered COVID-19 patients and are designed to mimic the body’s immune system to fight coronavirus.) When given to newly diagnosed COVID-19 patients in the study, monoclonal antibodies caused a statistically significant decrease in the patient’s viral load AND, most importantly, a 75% reduction in the need for ER visits or hospitalization.
Currently, patients over 65 carry a 30% risk of needing hospitalization. This treatment seemed to bring that risk down to 6-7%. This is great news.
How would it work? Unfortunately the treatment is not in pill form. It’s administered intravenously for 15 minutes—one time only—and currently requires enrollment in a phase 3 outpatient trial. If approved down the road, it would require a visiting nurse to come to the patient’s home on the same day of a new COVID-19 diagnosis.
As a result of this emerging data, the monoclonal antibody treatments made by Regeneron and Eli Lilly are being reviewed by the FDA for EUAs.
So much good news. But we have a long way to go before any vaccine or therapy is FDA approved and distributed widely.
So before we get too excited, we need to be realistic about what’s happening now—and what lies ahead.
Hope is necessary but unfortunately not sufficient to get us through.
COVID-19 continues to surge in the U.S. We’re now seeing well over 100,000 cases per day. Modeling predicts approximately 400,000 cumulative deaths by February 1, 2021. Daily deaths are predicted to gradually increase from approximately 930 daily deaths currently to approximately 2200 by February 1. If social distancing mandates continue easing, daily deaths are predicted to increase to approximately 6100 by February 1. However, we could reduce that number to 1300 daily deaths if 95% of the public were to wear a mask.
The best way to prevent COVID-19 still is not to get exposed to coronavirus in the first place. Until we have a vaccine (or two) and widespread treatments like the above, we’ve got to DOUBLE DOWN on preventative measures to save lives and reduce suffering. Remember that even if you are at lower risk for complications of COVID-19, your infection is still a link in the chain for other people getting sick and potentially dying.
At the risk of beating a dead horse, I’ll review MOSHPIT, the acronym for COVID-19 prevention that I came up with back in the spring. It still applies. Why? Our own behavior is still our best defense against COVID-19. Cases are surging not because the virus has changed since March but because human behavior has.
M = wear a Mask. It’s an essential public health measure. Your mask should be a well-fitted three-ply cotton, heavy duty two-ply cotton, or surgical (without a valve).
O = Outdoors is twenty times safer than indoors. The breeze carries respiratory droplets away, helping prevent us from inhaling them and getting sick. But it’s not a hall pass! Masks and social distancing are essential for optimal protection outside.
S = Socially distance. We’ve got to stay 6 feet apart to keep ourselves and others healthy. This is particularly important as we migrate indoors in the cooler weather.
H = Handwashing. We no longer need to wipe down groceries or take-out boxes as long as we wash our hands after touching these surfaces. Coronavirus is extremely wimpy against soap and water and hand sanitizer.
P = Personal and public responsibility. We need to take care of our mental and physical health. We also need to respect and protect our neighbors. When we all work together, we’ll shut this beast down.
I = Information and facts can literally save your life. Decide who you trust. CDC.gov is a great resource. The TWIV (This Week in Virology) podcast is fantastic. You can stick here with me, too. But my best advice? Find a few sources, and always trust science.
T = Talk to your doctor. Manage your underlying health, get your physical, stock up on your medicines, and know when to call for advice. And get your flu shot! (My flu FAQ is HERE.)
Note that no single MOSHPIT measure alone will eliminate your infection risk, but layering these elements is the best way to protect yourself and others.
Even though an actual mosh pit is the last place you should be right now, use this acronym to stay safe while science and hope work side by side.
I will check in later this week. Until then, be well.