COVID Update — Back to Normal vs. Summer Surge

In late spring and early summer this year, COVID-19 in the U.S. was at its lowest ebb since the first months of the pandemic. Life seemed to be back to normal for most people. Even the more cautious among us resumed in-person shopping, dining out, attending church services, going to movies and concerts, and gathering for parties and other social events. Mask wearing became increasingly rare.

It felt wonderful; it was liberating. We were ready to move on! We didn’t completely forget COVID. You never forget fighting for breath through congested lungs or watching a loved one die, but even these memories blur with time. COVID was no longer the first consideration in every decision we made.

Meanwhile, SARS CoV-2 has been doing what viruses are designed to do — adapting to survive. New variants better able to infect people and evade the immune protections from vaccination or previous infection survive, spread, and evolve more variants. COVID remains, as it has always been, a moving target.

Scientists must tailor new vaccines to keep new variants from repeating the ravages caused by original SARS CoV-2, Delta, and Omicron. At the same time, given the incremental nature of science, researchers are still working to understand exactly how COVID affects the body and how to repair or prevent the damage when people get infected.

The National Library of Medicine’s PubMed database has added almost 50,000 articles from professional medical journals so far this year. (That’s fewer than in the past two years, probably because research has become more focused as more is learned, but it indicates the new normal in medicine.) Clinicaltrials.gov lists more than 200 COVID studies currently recruiting participants.

As we have said before, as bad as this pandemic has been, we have made incredible progress. A recent meta-analysis of 42 studies in Reviews in Medical Virology showed that “Paxlovid effectively reduced the risks” of dying, being hospitalized, going to the emergency room (ER), being admitted to intensive care, and needing extra oxygen. (Unfortunately, many people who could benefit from Paxlovid don’t get it, and we need to do better on that.) Paxlovid may also help to prevent long Covid, although more studies are needed to confirm this.

Other treatments are available, too. Molnupiravir is less effective but helpful to people who can’t take Paxlovid, which interacts with various medicines. Another antiviral, Remdesivir, is effective but not suitable in all circumstances. Like Paxlovid, these drugs are FDA-approved. Several drugs that reduce inflammation are also approved and available, but again, only for certain situations, such as severe illness in hospitalized patients.

Convalescent plasma, which has antibodies from people who have recovered from COVID, can be used but the evidence is still unclear. A recent meta-analysis of 34 studies suggests that convalescent plasma reduced the need to be hospitalized and may keep ICU patients from more severe illness.

Other treatments being investigated include interferon lambda and mesenchymal stem cells. Breath analysis and saliva swabs are being evaluated as more pleasant alternatives to probing our noses to test for COVID.

Learning what doesn’t work is just as important as finding what does. Negative findings help to apply resources where they will do the most good and protect people from harm. For example, meta-analyses of numerous studies have shown that ivermectin does not prevent or relieve COVID. No news can be good news, too. Investigators have found that being vaccinated during pregnancy has no adverse effects on mothers or their babies.

We know now that long COVID (or Post-Acute COVID-19 Syndrome in medical terms) is real, complex, and often debilitating. Scientists are starting to unravel the mechanisms that cause persistent fatigue, shortness of breath, brain fog, and other symptoms after recovering from COVID. Following unexplained (and possibly inexcusable) delays,

NIH (the National Institutes of Health) is finally starting clinical trials for long COVID. The studies will include electrical stimulation for brain fog, drug therapy for sleep problems, and treatments for digestive, breathing and heart rate problems. You can still join at https://recovercovid.org/.

We have many reasons for optimism.

However, after 6-7 months of declining statistics and the lowest rates of ER visits, hospitalizations, and deaths to date, we are seeing an uptick. 9,056 people with COVID were admitted to U.S. hospitals in the week ending July 29, a 12.5% increase over the previous week. In Lycoming County that week, 8 people were hospitalized with COVID. ER visits for COVID symptoms are also up. Deaths have not increased; at least, not yet.

Is this the beginning of a serious summer surge or a bad winter ahead, as in past years? Not necessarily. The numbers are still very low. Let’s keep them low by staying current with vaccinations and taking those commonsense precautions we’ve heard so often.

Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!,
Published: 8/12/23

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