On Monday, President-elect Joe Biden announced his COVID-19 advisory board. While that board doesn’t currently contain some necessary experts—like NIH infectious disease specialist Anthony Fauci, who is currently busy being belittled by Donald Trump and threatened with beheading by Trump’s former campaign chief—it does showcase a list of notable experts in every area of public health.
On the same day, pharmaceutical giant Pfizer announced the first results out of the Phase 3 trial of its COVID-19 vaccine. Those results indicate an effectiveness of greater than 90%, providing great hope that when the vaccine is available, sometime early in 2021, it will signal that the great pandemic is near an end. The news was greeted with relief by the stock market, and by a pandemic-weary nation. And, of course, it was treated as a sign of yet another conspiracy by Republicans who are convinced that Pfizer held off on the announcement until after the election. Though not one of them seems to have any idea why the drug manufacturer would have made such a move.
Meanwhile, the third surge of virus in the United States is only getting worse, making every move by Biden’s team more critical—and every day of neglect from Trump more deadly.
Mondays are usually a relatively low day for the number of cases reported, as states are still noting results from testing that took place over the weekend when many facilities are closed. But this Monday, the United States still notched up 127,000 additional confirmed cases of COVID-19. A week earlier, that would have been a record high. It’s also almost 40,000 cases higher than were reported the previous Monday. At the rate cases are soaring, it seems certain the United States will pass 150,000 cases in a single day at some point this week.
This latest surge of virus continues to be extremely broad-based. Both Illinois and Texas exceeded 10,000 new cases on Monday. Already on Tuesday, Illinois has announced 12,623 new cases, obliterating the state’s past record. It’s actually the highest value that any state has posted since Florida and Texas soared back in July, and higher than any daily number posted by New York in the opening phase of the pandemic (though limited testing at the time meant that cases in New York were badly underreported). An astounding 17 states reported over 3,000 new cases on Monday.
Just a few points out of the morass of statistics: Illinois now has 4,742 people in the hospital with COVID-19, with 911 in the ICU, and 399 on ventilators. In North Dakota, 7.4% of the total population has now tested positive for COVID-19. Tennessee had as many cases in the past two days as it had in the entire pandemic up until mid-June.
Over time, the case fatality rate for new patients has decreased. But, so far at least, it’s hard to point at any miracle drug that accounts for this change. Trump’s much promoted hydroxychloroquine was never more than a pipe dream. Remdesivir, which seemed to represent a net positive for patients in mid-disease and gained FDA approval, has turned out to show no real effect in the largest trial to date. The only real advances seem to be in the use of anti-inflammatory steroids with patients who need supplemental oxygen or ventilation. If there’s any good thing at all to come from the pandemic so far, it may be that doctors have acquired a better understanding of how to conduct long-period intubation while decreasing damage and lowering the rate of death—for the awful reason that they’ve had so many patients on which to test different procedures.
Synthetic monoclonal antibody treatments, such as the Regeneron treatment given to Trump during his bout with the disease, do hold out a lot of hope for effective treatment. On Tuesday, Eli Lilly gained emergency approval for its version of a two-antibody cocktail, bamlanivimab. However, at the moment there are very few doses available. The total output of both Eli Lilly and Regeneron to date would not be enough to treat the positive patients of a single day at this point, and since the treatments are most effective when administered early, they’re not really a significant factor on the total national picture—even if they are of powerful net benefit for those patients lucky enough to receive one of these rare treatments.
However, Pfizer’s vaccine announcement is genuinely good news. And it’s not just good news for Pfizer’s vaccine, or even just good news for COVID-19.
- The Pfizer vaccine’s high efficacy is fantastic news, because the vaccine targets the spike protein that COVID-19 uses to attach to human cells. The other “big four” vaccines now in Phase 3: Oxford/AstraZeneca, Moderna, and Johnson & Johnson also target that same protein. That means the world is likely to have a variety of effective vaccines, some of which may be easier to administer and easier to use in areas without extreme refrigeration.
- Pfizer’s vaccine is the first phase 3 trial of a vaccine using mRNA in a human. If the safety data holds up, the technology could potentially become a new standard in how vaccines can be rapidly developed against other diseases.
- Moderna’s vaccine is also mRNA based. Unlike Pfizer, they’re a relatively small company that has essentially bet the farm on this trial. They should be reporting their Phase 3 results within the next two weeks.
Johnson & Johnson’s vaccine has some advantages in that it’s a single dose and doesn’t need temperatures lower than those provided by normal refrigerators. Their single dose approach means they should move through Phase 3 more quickly. However, they were the last of the major trials to begin, and they’re recruiting a large pool, so don’t expect results for another month or more.
And of course, the best news possible is that it won’t be Donald Trump who handles the deployment of these vaccines. This isn’t Biden’s first experience in crisis management. After all, he walked into the White House in 2009 in the midst of the Great Recession and took charge of Obama’s response to that crisis. He’s used to managing large teams in dire circumstances.
Now we just have to survive until vaccines—and Biden—arrive.