In 1918, the "Spanish Flu" struck the United States. The Centers for Disease Control and Prevention (CDC) tells us, "The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918.
"It is estimated that about 500 million people or one-third of the world’s [then] population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. Mortality was high in people younger than 5 years old, 20-40 years olds, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic.
"While the 1918 H1N1 virus has been synthesized and evaluated, the properties that made it so devastating are not well understood. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly."
Undoubtedly, more U.S. residents will die from COVID-19. But up until recently, our country has had little more to control the pandemic than it had in 1918-19. Since March, our president and governors have dealt with the pandemic very much like their predecessors dealt with the Spanish Flu: through non-pharmaceutical interventions, such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which have been applied unevenly.
With the exception of antibiotics to deal with secondary infections, the doctors have not had much else. While results have significantly improved, the initial use of mechanical ventilators did not come close to producing the desired survival rates.
But now, after only nine months, vaccines are expected to be available for use in the U.S. within a matter of weeks. Pfizer and BioNTech, working together, have applied for emergency use authorization from the U.S. Food and Drug Administration (FDA) for their vaccine. Moderna's application is expected to follow in early December. And AstraZeneca and the University of Oxford hope to have their two-dose shot available around year's end. General Gustave Perna, President Trump's head of Operation Warp Speed, has said repeatedly that vaccine distribution will begin within 24 hours after an authorization is issued by FDA.
Perna has also advised that by Dec. 31, 2020, Operation Warp Speed expects to have about 40 million doses of the two vaccines available for distribution. Both vaccines each require two doses, given 21 and 28 days apart. Forty million doses, therefore, would be sufficient to vaccinate about 20 million people. People at high risk will be prioritized.
As more vaccine become available in the new year, it will be distributed. Dr. Anthony Fauci, expects the vaccine to become available for use by the general public in April 2021.
At the same, treatments are becoming available. On October 22, the FDA approved the antiviral drug Veklury (Remdesivir) for COVID-19 treatment in adult and pediatric patients, ages 12 and older, weighing at least 88 pounds, and requiring hospitalization. It is an antiviral given intravenously.
Other pharmaceutical companies are developing monoclonal antibody therapies. GoodRx explains that antibodies are proteins made by the immune system to help fight infections. They bind to foreign pathogens, such as viruses; they help destroy them. Monoclonal antibodies are antibodies made in a lab. It can take weeks for the body to develop natural antibodies. Using MABs can thus potentially fight off infections sooner.
Even if Americans can't agree politically, this Thanksgiving we should all be thankful for the work of America's great pharmaceutical companies.
First Published in the Moline Dispatch and Rock Island Argus on November 26, 2020
Copyright 2020
John Donald O'Shea
