In a sobering message to physicians and their patients, the United States’ top infectious disease official suggests the rampaging SARS-CoV-2 pandemic is going to be with us for a while.
“We are now in the middle of an explosive pandemic of historic proportions, the likes of which we have not experienced in the last 102 years with over a million deaths worldwide and 38 million cases – and the end is not in sight,” Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said as keynote speaker at the virtual annual meeting of the American College of Chest Physicians.
“Unfortunately for the United States, we are the worst hit country in the world,” Fauci said in his pre-recorded speech. The U.S. case count surpassed 8 million and the death count was nearing 220,000 over the weekend.
Fauci noted that the U.S. government is deeply involved in vaccine development, supporting six different candidate vaccines, including five now in phase III trials. “Our strategic approach means we are harmonizing these vaccine trials so they have a common data monitoring and safety board, common primary and secondary endpoints, and common immunological parameters,” he said.
Two of the pivotal trials were initiated in late July, Fauci said. “Given the rate of infection that has gone on in this country and the distribution of the clinical trial sites involving tens of thousands of volunteers, we project we will have an answer as to whether we have a safe and effective vaccine by November or December of this year,” he said. “It may come earlier this month, but that is unlikely.”
“Based on the data that we have seen from animal studies, and the data from the phase I trials,” Fauci said, “which indicates that the vaccine induces a robust neutralizing antibody response, equivalent, if not greater than natural infection, we are cautiously optimistic – again, with never a guarantee – that we will have a vaccine that would be safe and effective by the end of this year, and we will be able to distribute doses at the end of this year and throughout the beginning and middle of 2021.”
While COVID-19 is a novel and deadly virus, it is not the only coronavirus that has infected humans over the years. “We have been dealing with coronavirus outbreaks for decades and decades and decades,” Fauci said. “About 15% to 40% of all the common colds that we repetitively experience during the winter months are due to coronaviruses.”
“Additionally, there were pandemic coronavirus outbreaks such as SARS and MERS,” he said. “The Middle East respiratory syndrome is still smoldering in Saudi Arabia and the Middle East, where as the severe acute respiratory syndrome coronavirus [closely related genetically to SARS-CoV-2 which causes COVID-19 disease] spontaneously disappeared because of very aggressive and successful public health measures such as isolation, identification, quarantine, etc.”
But COVID-19 is not disappearing, and it is out of control in the U.S., he suggested. Fauci illustrated that the differences between the U.S. and Europe showed how containment methods were able to reduce cases. “The European Union had their peak slightly before we did in the U.S., but once their peak burned out and was under control because the countries shut down methodology, their case rate per day went down to a very low baseline level – well below 10,000 new cases a day.”
“While in the United States, when the Northeast went down to a low baseline, the rest of the country started to spike, and that is the reason we never get down to the level that the European Union did. We went along at the rate of about 20,000 cases a day for a couple of months until the attempt to open up the economy in the summer months in the southern states led to a surge of up to about 70,000 new cases a day which then came back down and has now plateaued somewhere between 40,000 and 50,000 cases a day, a level where we don’t want to be,” he said.
Fauci said that when researchers compared how the U.S. compared with the European Union in mobility, Americans did not halt public and social activities, such as going out to work and shop, as much as Europeans did.
He also reviewed some of the basic statistics on COVID-19. Fauci cited one study indicating that about 40% to 45% of infections are asymptomatic. Among symptomatic cases, 81% involve either mild or moderate symptoms; about 14% of cases are considered severe, and 5% are classified as critical. The current fatality rate is 2.3% for patients with confirmed SARS-CoV-2 infection.
Elderly Americans (85 and older) are hospitalized with COVID-19 at a population level of nearly 1% — 890 per 100,000. The rate declines with age, such that it’s less then 200 per 100,000 for those younger than 50.
Source: MedicalNewsToday.com
