COVID-19 cases and hospitalizations remain ever present in the U.S., and experts warn of more powerful variants emerging as the virus continues to spread and mutate globally. At the same time, researchers are working on what they hope will be more effective vaccine methods and treatments for both the acute disease and the lingering, long-term effects of long COVID.
“It’s probably 10 times or 15 times higher at the minimum than what we’re measuring right now,” she said of current national counts, which are tallied from tests performed by hospitals and other health care providers. “Rapid tests don’t get reported, so we don’t have a good view into the actual level of infection that exists in the United States.”
“I would rather just increase the likelihood that they would get it on an annual basis,” she said. “It just will become something that we have to factor into our kind of preventive medicine approach to keeping ourselves healthy and taking care of ourselves and our families on an annual basis.”
As for whether annual vaccines could one day no longer be needed for COVID-19, that’s looking unlikely, at least for the foreseeable future. That’s in part because of how quickly RNA viruses like SARS-CoV-2 ― the virus that causes COVID-19 ― and influenza mutate, which can lead to vaccine resistance, said Hassig.
“This virus mutates as it moves from person to person to person,” she said. “That’s the challenge with these organisms, that they’ve got a mechanistic way of reproducing and if we don’t behave in a way to make that less successful, they’re just going to keep doing what they do. Disruption of transmission is a really valuable thing.”
“Delivering vaccines to the nose and airways is one of the most promising ways to achieve immunity within the airways, which could stop mild COVID infections and transmission of the virus more effectively than injected vaccines,” Dr. Adam Ritchie, Oxford University’s senior vaccine program manager, said in a recent press release on his university’s collaboration with pharmaceutical company AstraZeneca on a nasal spray. “It also has the advantage of avoiding use of a needle. Many parents will know that nasal sprays are already used for the flu vaccine offered to schoolchildren in some countries, including the U.K.”
“China is really scary, frankly, not just for the impact on them alone, but the likelihood that there are lots and lots and lots of infections happening, and this virus mutates as it moves from person to person to person,” she said. “There’s no way to predict what the variant is going to be like.”
“My biggest concern always is that we’ll get another variant that would have the transmissibility of omicron combined with the lethality of delta,” LaVeist said, referring to the current and past dominant variants. “Put that together, that would be the Frankenstein version of the virus, and that variant would be very problematic, especially if the new multivariant booster wasn’t effective against it. There’d be some period of time where we’d have to catch up.”
China reopened its borders for international travel on Sunday, allowing its citizens to travel abroad for the first time since the pandemic began without wide restrictions under its strict “zero COVID” policy. Numerous countries, including the U.S., responded by mandating negative COVID-19 tests from travelers arriving from China, prompting backlash from Chinese officials who called the requirement excessive and unacceptable.
LaVeist believes public focus may eventually need to turn from preventing coronavirus infection and instead to COVID-19 treatment options if vaccine rates don’t go up and public education doesn’t improve. This “curative care model,” as he puts it, would focus on treatments like prescription or over-the-counter medications.
“That’s the way we manage influenza. People get the flu and then they go to the supermarket or the drugstore, they buy over-the-counter medications to try to manage the symptoms,” he said. “Well, with COVID, we will have therapeutics that should be more effective than just over-the-counter remedies that deal with symptoms.”
“Wherever there are crowds, and by that I mean a dense urban population or a crowded social environment, there’s the possibility of transmission of a respiratory virus,” said Hassig. “I still don’t go anywhere in a public setting without a mask on and I would encourage people to do the same.”
“I think that even people who are well informed, who have a very sophisticated understanding of this, can become complacent. I’m one where it happened with me,” he said of his own COVID-19 diagnosis last year after going maskless on a plane.
“Flu is very well transmitted by children, and they suffer some pretty severe consequences from flu as well. COVID is not as impactful on children but still has some very serious consequences for some of them,” said Hassig, who credited mask use and remote learning for the significant drop in flu cases in the midst of the pandemic.
“I think people should be paying a lot more attention to [long COVID] as a possible outcome if they become infected. It’s not necessarily all about the acute disease experience with this virus.”
“We are getting a better sense on the basic-science level about some of the physiologic abnormalities in long-COVID, but there is more work still to do in this area to truly have a unified understanding of the causes of symptoms, although it probably won’t be the same for everyone with long-COVID,” said Dr. Benjamin Abramoff, director of the Post COVID Assessment and Recovery Clinic at the University of Pennsylvania in Philadelphia. He added that a cure is likely nowhere near on the horizon.
Like Schamess, Abramoff said his clinic has seen a steady flow of long-COVID patients, with spikes that generally follow spikes in acute COVID-19 cases by a few months. At the Wexner Medical Center, Schamess said there’s a waiting list of 60 to 70 people seeking treatment.
“There’s just more demand than we can meet,” he said, expressing frustration that there aren’t more physicians who are knowledgeable about the condition or who are taking it seriously. “A lot of the patients I see have already been to many physicians who’ve told them ‘It’s all in your head’ or ‘It’s not for real,’ ‘Maybe it is for real, but we don’t know what to do about it,’ or giving them kind of off-the-cuff advice, which doesn’t really help them.”
“It may be Victorian medicine, but sometimes that’s what people need to hear, and other times it’s medications and other times it’s more sophisticated things,” he said, while imploring employers to be more accommodating to their employees.
“Apart from what doctors and scientists can do, it’s important for employers to understand how disabling this condition is,” he said. “If you’re an employer, if you simply allow your [employee] to get the rest they need and have some accommodations and go back to work slowly and pursue a course of therapy, you’re going to have that worker back.”
This content was originally published here.
