Covid Becoming Endemic

 

We’re learning new epidemiology terms. An epidemic is a sudden increase in the number of cases of a disease in a particular location. As Covid-19 began spreading in Wuhan, China, it became an epidemic.

An epidemic becomes a pandemic when that disease spreads across several countries and affects a large number of people. Covid-19 was declared a pandemic by the World Health Organization on March 11, 2020. They announced the number of cases outside China had increased 13-fold and the number of countries with cases had increased three-fold.

Lastly, a pandemic becomes endemic when a disease outbreak is consistently present, but limited to a particular region. For instance, malaria is considered an endemic in certain countries and regions, such as Africa. Influenza is endemic in the U.S., as well as the coronaviruses responsible for the common cold.

Could Covid-19 become endemic in the U.S. in the near future?

In an article published in Nature in January, almost 90% of infectious-disease researchers and virologists surveyed believed the Covid-19 virus will become endemic – meaning it will continue to circulate in pockets of the global population for years to come. “Eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic,” says Michael Osterholm, an epidemiologist at the University of Minnesota in Minneapolis.

More than one third of the respondents to Nature’s survey thought that it would be possible to eliminate SARS-CoV-2 (Covid-19) from some regions while it continued to circulate in others. “The virus becoming endemic is likely, but the pattern that it will take is hard to predict,” says Angela Rasmussen, a virologist from Georgetown University.

This survey was taken in January, 2021, and published in February, 2021. What about today? In August, former Food and Drug Administration commissioner, Scott Gottlieb, M.D., said “We’re transitioning from this being a pandemic to being more of an endemic virus, at least here in the United States and other Western markets. This is going to become more of an endemic illness where you see sort of a persistent infection through the winter, but not at the levels that we’re experiencing certainly right now.” He said booster shots will play a role in getting the U.S. to that phase, as will the Delta variant.

What does this mean for those of us living in the U.S.?

Consider how we are living with other endemic diseases. For the common cold, we take essentially no precautions whatsoever, apart from possibly staying at home from work or school, when it is at its peak. Most people don’t even do that. The reason is the common cold is self-limited and causes essentially no lasting effects. Few people die from this disease, except for those with severely compromised pulmonary conditions or immune systems, who then contract fatal other diseases like pneumonia.

For influenza, which is significantly more life-threatening, few people take more precautions than the common cold. The rates of influenza vaccination are only about 40% in the general population and 60% in the vulnerable, high-risk population. However, about 40,000 Americans die of this disease in an average year. It is interesting to note that the number of influenza deaths in 2020 was significantly lower, possibly due to the precautions imposed upon the population in response to Covid-19, or possibly under-reporting of influenza fatalities in the hysteria over Covid-19.

If we are looking for a silver lining in this cloud, it may be that more Americans will realize the importance of vaccinations for both Covid-19 and influenza in the coming years and will therefore lower the incidence of both. If you fail to get vaccinated, you are accepting the risks of both of these diseases. But the government and society never required extreme measures such as mask mandates, closed schools, vaccination passports, and social distancing for these other endemics, and it’s time to stop them for Covid, too.

We have learned to live with influenza for many years and we can do the same with Covid-19. My advice is to get vaccinated for both if you are able – or take necessary precautions like extra attention to hand-washing, avoidance of crowds, and possibly masking in close quarters. But that’s necessary to protect you – not your neighbor. Let your neighbor get vaccinated, or take his own precautions. It’s time to get on with life before the Covid pandemic just like we used to do with influenza – only smarter.

Undermining Future Drug Innovation

 

Just when you thought the value of a robust pharmaceutical industry couldn’t be more obvious, politicians now want to “kill the goose that laid the golden egg.” A year ago, we were desperate for a new vaccine to protect us from the Covid-19 scourge, and now some want to undermine the system that brought us vaccines in record time.

The Wall Street Journal editorial board puts it this way: “It’s one of the strangest, and most destructive, juxtapositions in political history. Even as vaccines are saving the world from Covid, the Democratic Party wants to rob these firms of the reward for innovation that is essential to developing future cures.”

The backstory on this fiasco is that Democrats are scrambling to pay for their massive $3.5 Trillion (or more) expansion of the entitlement state. Even taxing the rich even more (the top 1% pay 40% of all taxes) will only find $2.2 Trillion of new revenue, so they’re desperate to find more. They believe they can fill the gap with $500 billion in savings from price controls on drugs.

Democrats claim the bill would simply allow Medicare to “negotiate” what they deem “fair” prices as foreign governments with national healthcare systems do. The bill sets a price ceiling of 120% of the average drug price in Australia, Canada, France, Germany, Japan and the U.K. The HHS secretary could decide to pay less.

The bill directs HHS to focus on the 250 most expensive and common brand-name drugs without generic competitors. The secretary would be required to “negotiate” at least 25 drugs in the first year of the program (2025) and 50 in future years. If companies refuse the government’s price, they must pay a 95% excise tax on all revenue they generate from that drug in the U.S. They would also have to offer the government price to private insurers. This can hardly be described as a “negotiation” when the government is pointing a gun at their heads.

To analyze the impact of such legislation, the Journal of the American Medical Association (JAMA) published a study that estimates drug spending in the U.S. would have been 52%, or about $83.5 billion, less in 2020 based on the bill’s formula. The research company Vital Transformation estimates the bill would reduce bio-pharmaceutical earnings by $102 billion a year.

If you’re like most people, you think pharmaceutical companies can easily afford such cuts in their revenue and the public will never notice the difference. But consider that major pharmaceutical companies invested $91 billion in research and development in 2020. In other words, Democrats would be confiscating nearly all the profits companies use to finance their clinical research. Simply put – no profits, no research, no new drugs. No new vaccines when the world is desperate to fight the next pandemic.

WSJ says, “This tax on innovation would damage big pharma companies like Pfizer and Merck, but it would be a death blow to small biotech firms where many breakthroughs originate.” How important are these smaller biotech firms? Biotech startups patented nearly two-thirds of new drugs in 2018, and in their early stages they rely almost entirely on venture capital. Later they often cooperate with or license their discoveries to large drug makers. Only about 15% of drugs and vaccines that enter clinical trials are approved. The rate for oncology therapies is only 3%.

Most people think the new Covid vaccines were developed just since the start of the Covid pandemic. But these hugely successful mRNA Covid vaccines are the result of approximately ten years of study and billions of dollars invested in that research. Without this kind of R & D, there will be no new vaccines the next time a new virus emerges.

The bill would “immediately have the effect of putting many early-stage biotech companies out of business,” says Strand Therapeutics CEO Jake Becraft. He adds that Moderna would never have been able to raise capital if the bill had passed 10 years ago.

WSJ summarizes: “American drug innovation leads the world, and during the pandemic it has shown its capacity to save millions of lives. It would be a harmful act for the ages against public health if Democrats steal this vital industry’s incentive to produce the cures of the future.”

There’s an old saying, “There’s no such thing as a free lunch.” Add to that, there’s no such thing as new drug innovation without paying the cost of the research.

CDC Credibility Takes Another Hit

It’s been a bad year for the Centers for Disease Control and Prevention (CDC). I first wrote about this in February when new CDC Director Dr. Rochelle Walensky backtracked her recommendations regarding reopening schools without teacher vaccinations after the teachers unions objected. (CDC Credibility Gone) Apparently, the White House let her know she must change her opinion if she wants to keep her job.

Seven months later the CDC is still underwater when it comes to its credibility. Dr. Marty Makary, professor at Johns Hopkins University School of Medicine, tells us in The Wall Street Journal the CDC has failed to provide the information needed to inform a sound Covid strategy. Despite a wealth of data from our own Covid experience, he says the CDC is relying mostly on studies out of Israel to make policy decisions.

The Biden administration can’t rely on CDC studies to justify its booster vaccination plans since they have no studies of their own. Studies from Israel show that a booster resulted in a 10-fold reduction in severe Covid illness in people over 60. The results were published mere weeks after the study’s completion, not months later as often happens in the U.S.

Makary wants to know why the CDC didn’t produce their own research to answer these questions. The agency has 21,000 employees and a $15 billion annual budget. It has data on more than 40 million Americans who have tested positive for Covid and 200 million who have been vaccinated. This data includes vaccine type, dosing schedule, and vaccination date. With this data, calculating the rate of U.S. breakthrough infections and deaths he calls Epidemiology 101.

He also criticizes their lack of vital data on natural immunity – the protection patients receive when they recover from Covid infection. Israel published an important study he calls “powerful and scientifically rigorous” on this subject to date. In a study sample of more than 700,000 people, natural immunity was 27 times more effective than vaccinated immunity in preventing symptomatic infections. Yet U.S. public health officials continue to dismiss natural immunity, insisting that those who have recovered from Covid must still be vaccinated. This opinion is being parroted by the media and other policy makers who are sticking by their original hypothesis that natural immunity is fleeting, even though at least 15 separate studies show it lasts.

Dr. Makary says, “The CDC shouldn’t fish for data to support outdated hypotheses. Heeding the robust Israeli data on natural immunity could help restore the agency’s credibility and even help vaccination efforts.”

There is also important information coming out of Israel regarding vaccinations in children. Researchers found that one dose of Pfizer vaccine, instead of the normal two, was 100% effective in children ages 12 to 15. This is a significant finding since it could have huge implications for achieving broad immunity in adolescents while reducing the risk of heart complications, which have been seen in some after the second dose.

Dr. Makary concludes, “These are the studies U.S. public health agencies should be doing but aren’t. By any metric, the CDC has failed in its primary task of preparing the country for a pandemic and telling us how to reduce harm from the novel Covid pathogen.”

The CDC is our primary health agency whose mission is to accurately inform us on matters concerning our health and the prevention of disease. Sadly, they are failing in this mission and letting politics interfere with good science. In a perfect world, we could rely on them to provide us the most up-to-date scientific research to inform policy makers, but it seems the policy makers are the ones informing the CDC.