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In addition to the search for an effective treatment for acute COVID-19 infection, other avenues to combat the virus include monoclonal antibodies and challenge trials of candidate vaccines.

Monoclonal Antibodies

Monoclonal antibodies are antibodies that are utilized against a specific bacteria or virus. One way that they are “manufactured” involves recovering the immune cells of people recuperated from COVID-19.

The immune cells of specific interest are those that make antibodies to the SARSCov-2 virus. After isolating, from these specific immune cells, the genes that code for the components of the antibody, the genes can be used to “mass produce” these neutralizing antibodies.

These antibodies could then be introduced into an individual with severe illness from the infection to help fight it off. There is also the potential to use these antibodies to prevent infection. Those settings could include pre-exposure usage or post exposure usage.

Pre-exposure use, for example, could help front-line responders and health-care workers by reducing their risk of infection while treating patients. Post-exposure use would be utilized in the setting of someone who was exposed to a person with active Covid-19, in order to prevent the virus from establishing and multiplying in that exposed person. 

Challenge trials

Assessment of new vaccines involve a number of steps before they are made available to the public. One of the last steps involves randomized trials comparing individuals receiving the new vaccine with individuals receiving a placebo vaccine.

The subjects then go about their usual activities and subsequently a comparison is made between those receiving the new vaccine and those receiving placebo. Those comparisons involve the percentages of people acquiring the disease in question, the severity of illness between experimental and placebo individuals who do get sick, and the incidence of adverse effects between the two groups.

Because of the random nature of naturally acquiring infection, it can take a long time before enough people get infected in order to do an adequate assessment of the trial vaccine.

Josh Morrison, an attorney, founded a group called “1 Day Sooner.” The overall goal of the organization is to get an effective COVID-19 vaccine available more quickly than by the conventional means of vaccine development. The goal of this group is to get a significant number of people to sign up for a challenge trial of COVID-19 vaccines.

Compared to a conventional clinical trial, a challenge trial involves deliberately exposing the subjects to SARS-CoV-2 virus in a controlled, quarantined environment instead of waiting for patients to be randomly exposed to SARS Covid-2 virus in a normal natural environment.

The idea is basically to reduce the time needed to evaluate the effectiveness of the trial vaccine. Challenge trials have been used in the past to test vaccines for a number of diseases such as malaria and influenza. However, there is a major difference between this proposed challenge trial and past challenge trials.

Previous challenge trials have involved diseases for which there are proven effective treatments. So individuals who got sick during these trials would be able to receive conventional treatment. Challenge trials for COVID-19 would be far riskier because there is no proven, safe, effective treatment for COVID-19.

This has raised a number of ethical and other concerns. Given the paucity of knowledge about Coronavirus, some medical ethicists question whether a participant could truly provide informed consent.

Others suggest that because of the global impact and death toll of COVID-19, the ground rules for these type of studies should be changed. For those interested, an excellent discussion of this topic can be found in the July 7 edition of the Journal of the American Medical Association (JAMA) 

Opinion on masks

I am truly surprised at the number of people who have opted not to wear masks where distancing of 6 feet is not possible. There is good evidence that wearing masks helps lower the transmission and infection rate of Coronavirus.

What is also amazing is how militant some individuals have been about opposing these directives and mandates. A recent story recounted how a number of people at an anti-mask rally ended up trying to intimidate a pastor who was having his own protest about a totally unrelated subject.

Please don’t be like this. Don’t be the type of person who refuses to do a minimally inconvenient task because it’s perceived to be infringing on your rights. This minimally inconvenient practice is helping to protect your family, your friends, your neighbors and your fellow citizens.

Be the type of person who will do this for the good of your fellow man and who will do this because the scientific experts recommend it. 

 Each of us can choose to be part of the solution, or to be part of the problem. 

The writer practices at the Hampshire Memorial Hospital’s Multispecialty Clinic. The Clinic provides not only primary care services but also specialty care in the fields of general surgery, cardiology, gynecology, gastroenterology, podiatry and wound care.

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