On the 12th day of Christmas, Corona gave to me…

First, I need to give credit to Radiolab (A Terrible Christmas Special – 12/23/20) for the idea for the title. Indeed, what a terrible year this has been, on so many levels. However, for today, I’ve had enough negativity, and on this Christmas Eve, I’d rather talk about some of the good things our society has received this holiday season (not to mention the wonderful gift of my wife being at home).

Not One, but TWO Coronavirus Vaccines

I’ll start with the most exciting news first; the long-awaited COVID-19 vaccines are here! Earlier this month, Pfizer-BioNtech’s mRNA based COVID-19 vaccine was given emergency authorization for use in preventing COVID-19. Just this week, a second vaccine from Moderna was authorized as well. Vaccines are the safest and most effective way for us to obtain herd immunity as a society and finally tame this pandemic.

At my hospital, we have been planning for this day for the past several months. The sight of our first vaccine delivery early this week was a huge relief. On the same day, we started vaccinating employees at the hospital. I personally prepared over 150 doses of the vaccine and received one dose myself. I also helped provide several hours of education and coordinated the scheduling of vaccines for the pharmacy staff. It was very fulfilling work. Not often as pharmacists do we have the opportunity to participate in dramatic life-saving efforts.

For those of you who may not know, I’ll explain a little bit about what makes these vaccines great and why I was first in line to get one myself. First, in a study of about 30,000 people, the vaccine reduced the risk of contracting severe COVID-19 by 95%. This is outstanding effectiveness. The seasonal influenza vaccine usually runs between 30-50% effectiveness. This degree of efficacy is nearly unprecedented in this type of infection.

Second, the novel mechanism of the vaccine is scientific genius and pharmaceutically elegant. A crucial tenet of medicine is to always have a favorable risk and benefit ratio, doing the least amount of harm as possible. Drugs that have many effects are usually considered to be “bad,” because often those effects are not helpful (thus called side effects or adverse effects). Well, these early COVID vaccines are extremely precise and limited in their side effects. The mechanism, using mRNA, is everything we look for in a therapy; it is extremely specific (it does one thing only), it does not last very long (mRNA breaks down shortly after it is used to make proteins), and it has very little toxicity and few side effects.

In my personal experience, my arm was a little sore the next few days, and I did feel a little more tired than usual the next day. However, I was able to go to work without issue and I feel fine now. I do know at least one coworker who felt bad the next day, but was fine after that. It is no worse (and possibly better) than any other vaccine.

This is a true Christmas blessing. The only thing that makes me happier right now is having my wife at home.

Whoa, Black Betty, Bamlanivimab

Another thing that came about in the last few weeks is the emergency authorization of two products that can be used for active COVID-19 infections; bamlanivimab (Eli Lilly) and casirivimab and imdevimab (Regeneron). These are the first two therapies that specifically target SARS-CoV-2, the virus that causes COVID-19. They are currently being used in high risk patients to help reduce their risk of progressing to severe disease.

In my new role, I spend a lot of time in clinical rounds in the ICU. Most of the time, one entire half of our ICU is devoted to COVID-19 patients. Many of them do not survive. Treatments like these monoclonal antibodies have the potential to prevent infected individuals from ever making it to the ICU to begin with. This is extremely important. I cannot express how disheartening it is as a healthcare worker to see these COVID patients suffering and dying in the ICU, and there’s next to nothing we can do about it. Preventing them from getting to that point to begin with will go a long way in mitigating the impact of this disease.

Take It All Down, (Covid) is Over?

—“Boxing Day” by Relient K

Well, I think that’s a little bit premature. Covid certainly isn’t done yet. Currently, it is spreading at alarming rates, spurred on by the cold weather which has driven people inside and squeezed the protective humidity from the air. It is still vitally important for us to continue social distancing, wearing masks, quarantining when we have symptoms, handwashing, and using humidifiers. However, it does seem like there may finally be a light at the end of the long tunnel. If our vaccination programs are successful, and our monoclonal antibody therapies can help prevent severe disease progression, we will no longer have anything to fear from this virus, and we can return to life as normal. I, for one, cannot wait to eat a proper meal out again in a restaurant or hug my grandparents. Residents of long term care facilities and patients in hospitals need visitors. Our economy needs to get up and running again. We are so close. We just need to hold out a little longer. Hopefully that is the last gift of Christmas of 2020, to give us all the stamina we need to tow the line for a few more months to allow the vaccine to do its work and get things under control.

Final Thoughts

Though this hasn’t been the type of update many of you have become accustomed to, I hope you found it informative. If there’s a topic you’d like me to cover, or if you have questions you’d like me to address about Covid, please share in the comments or contact me personally. Thanks for reading!