Friday, June 24, 2022

Eric Topol: don't relax the fight against COVID

The pandemic and the boiling frog story (July 19, 2022)
If we turn to the boiling frog apologue “The premise is that if a frog is put suddenly into boiling water, it will jump out, but if the frog is put in tepid water which is then brought to a boil slowly, it will not perceive the danger and will be cooked to death.” No, we’re not going to get cooked and deaths won’t rise anywhere near the 4,000+ per day levels we have previously seen. But we’re not adequately perceiving the threats that the evolving virus is presenting to us: its fitness is gradually getting enhanced and this is happening at the same time as a constant building of our immunity wall.

BA.5, Chapter 2 (July 11, 2022)
Yes, I called it the worst variant we have seen so far, which The Washington Post editorial board picked up on (and checked with multiple peers before publishing) because of its severity of immune evasion and transmissibility compared with any prior SARS-CoV-2 variant. Not because it causes worse illness, which is still unclear ...

The BA.5 story (June 28, 2022)
My recent posts about our Covid capitulation and the risk of reinfection have tried to hammer home the imperative of next-generation vaccines (pan-coronaviruses, as described above, and nasal) but the frustration keeps mounting as we now confront unsatisfactory deliberations on variant chasing. Meanwhile, new versions of the virus (think: the time it took from Omicron BA.1 to get to BA.5) are accelerating and we’re not done yet, by any stretch. It’s frankly sickening to watch this virus continue to outrun us, knowing we are so damn capable of getting ahead of it.

A reinfection red flag (June 22, 2022)
New COVID Omicron variants BA.4/5 are both escaping vaccines and more infectious. Those who become reinfected display significantly worse medical outcomes on a range of measures (all-cause mortality, cardiovascular, and lung adverse outcomes, 3-fold risk of hospitalization and others). All purpose variant proof vaccines are not being developed aggressively.

A turning point in cancer (June 11, 2022)
Later

The bright side of the Covid pandemic (May 31, 2022)
The sheer breadth of disorders with a potential new, fresh approach, many of which have heretofore had no means of therapy or prevention, is staggering. We’ll look back at the pandemic someday as an extraordinary renaissance in biomedicine, giving rise to a validated pluripotent platform with seemingly unlimited refinements and applications.

The Covid Capitulation (May 16, 2022)
we have a highly unfavorable picture of: (1) accelerated evolution of the virus; (2) increased immune escape of new variants; (2) progressively higher transmissibility and infectiousness; (4) substantially less protection from transmission by vaccines and boosters; (5) some reduction on vaccine/booster protection against hospitalization and death; (6) high vulnerability from infection-acquired immunity only; and (7) likelihood of more noxious new variants in the months ahead

Climbing the ladder of infectiousness (May 5, 2022)
We will certainly get through the BA.2.12.1 challenge, but what’s to come? To debunk the myth, it is not true that variants will get less virulent over time—their evolution is unpredictable, as we have already seen. The problem that lies ahead is the many paths by which yet another noxious variant can show up. To anticipate this next Greek letter variant, we need broad neutralizing antibodies, vaccines that are protective across the beta-coronavirus or sarbecovirus family, and multiple effective medications beyond Paxlovid.

The priority and support for far better vaccines that would be variant-proof has not taken hold. Here is the current list with only a few in development that have reached clinical trials; there is nothing like the Operation Warp Speed accelerated, dedicated initiative that helped make the initial vaccines a major success.