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  • PublicHealthRising

Hope. Sort of.

Hope: There is some reason for long-term optimism. It’s not going to change anything today. Or tomorrow. And for each bright spot, there’s a shadow we need to talk about.

  • Better treatments. Not only have our clinical front lines (when they are not overwhelmed) figured out how to better care for COVID patients so they are less likely to die, new medications are coming online -- mainly antibody therapies. And they seem to work well, much better than remdesivir or anything else that has emerged so far. But supply is extremely limited and will be for some time. And a more significant shadow around this bright spot is staffing. Staff shortages will compromise how many people can receive these antibody treatments, which typically require an IV infusion over one hour, and then stays another hour for observation.

  • Vaccine development continues to be promising, with Colorado depots already prepositioning for expected FDA emergency use authorization. Doses could start being administered in December if everything stays on track. First doses would go to health workers / first responders at highest risk. Efficacy looks good. The shadow here is around safety. By the time this first vaccine comes out, it would have been administered to at least 20,000 people age 12 and older, who have been monitored for about two months. Is that enough people and enough time? The first vaccines we expect to see are based on RNA. It’s a new vaccine technology that has never been used in a licensed vaccine before, but all signs so far point to a reasonable short-term safety profile. But safety issues could emerge, either with an increasing number of people receiving the vaccine, or with an extended period of time for observation. It’s also possible there could be mid- or longer-term adverse effects we don’t know about yet. Any new medical technology is best approached with some sense of humility: the history of medicine is checkered through with overconfidence in the next best thing. I’ll tackle this in more detail in a future post, for now I think it comes down to risk vs. benefit, and the benefit to you depends on your potential exposure to COVID and the chances that you will develop severe illness. We also have other vaccines (non-RNA) coming around the corner ….

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