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Disease Specialist: Vaccine Developments Exciting, But Precautions Still Needed As Holiday Season Nears

Published: Monday, November 16, 2020 - 12:25pm
Updated: Monday, November 16, 2020 - 1:01pm
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LAUREN GILGER: The State Department of Health Services reported nearly 6,000 new cases of COVID-19 here over the weekend, and DHS is reporting 1,476 more cases today. That despite incomplete counts on Monday as weekend reporting often lags. In all, 6,302 Arizonans have now died due to COVID-related illness. Arizona has now confirmed nearly 277,000 cases of the virus since the beginning of the pandemic. And the recent spike mirrors an alarming trend across the country. The U.S. reported 1 million cases of COVID-19 in the span of just six days last week, bringing the nationwide total to more than 11 million cases since the start of the pandemic. There is some good news today, though: This latest spike comes amidst news that vaccines from Pfizer and Moderna are 90% effective or better — 95% in Moderna's case. But a vaccine won't be widely available before the holidays get here, and the current rise in cases could only get worse as people see family and friends for turkey dinner next week. I spoke to Dr. Anita Kohli more about all of this. She is an infectious disease specialist with Arizona Liver Health who is working on clinical trials related to the virus. I started by asking her about this news about vaccine success. Is it time to get excited yet?

ANITA KOHLI: It is definitely time to get excited. No, a lot has changed the last time we talked just probably eight or 10 weeks ago. The news around the vaccine for both Pfizer and Moderna — I think it has exceeded anyone's expectations of how efficacious a vaccine could be. They did show that with two doses of either vaccine, they could prevent 90 to 94% of infections in people who receive the vaccine as compared to placebo. These trials are still ongoing, so this is not the final data, but it looks efficacious, and so far it's safe. I think this interim data exceeds anyone's expectations. I do want to say, the data around efficacy is — we talk about that — what that means is that it was able to prevent infections [in those] who receive the vaccine as compared to placebo. The question that it doesn't answer in my mind is how long does this protection last for? So far, you know, what we're measuring is your ability to prevent infections for the duration after these patients receive the vaccines. So at this point, they would have had somewhere between four and five months of protection, potentially. But what we don't know is, is this infection going to last six months, a year, two years? What is the duration of this immunity that we're actually generating? And that's a very important question as well.

GILGER: Right. So I know you're also involved in clinical trials there at AZ Liver Health. Can you tell us how the process works, what you're seeing, what you've observed so far?

KOHLI: Sure. So we are involved not in the vaccine trials, but in trials for therapeutics, for the treatment of patients who have COVID. So these are the new monoclonal antibody therapies that, that have been in the news quite a bit recently as well. And an interim analysis of these trials for both the Regeneron monoclonal antibody as well as Eli Lilly drug in people who have COVID who are treated with these medications — they've shown that the medications can reduce viral shedding as well as reduce symptoms or the rate at which people get faster. So that is great news. The great leap of faith you take is that if you're thinking, "Hey, yes, we can reduce viral shedding and if we can reduce symptoms, that of course we're going to reduce hospitalizations and deaths using these medications." So, again, very, very exciting times that these options are being developed and great data on both sides here in both the vaccines space and the therapeutic space.

Arizona Coronavirus Cases, Deaths

GILGER: Yeah. OK, so let's turn then to the not so good news today. We are talking to you this morning as well because the U.S. and Arizona are seeing significant spikes in cases. What do you think is driving this at this point? And what do you think needs to happen to try to stem the tide?

KOHLI: You know, I think the biggest driver here is obviously everyone's desire to return to normality. That is life, doing things, going to restaurants, going to gyms, going back to school, going back to work. And all of us want to be doing those things, myself included. The key issue is here we have to be able to do these things safely. People need to be wearing masks, doing social distancing, avoiding large gatherings. And I think over the last few months, we as as Americans have become too lax about some of these things. And as a result, we're seeing the spread of the virus in our communities again. And it will continue to spread as long as we're relaxed about these restrictions, and something will need to be done. And obviously, we have to temper the ability to live a normal life and, care for our children and the elderly and with mental health and some of the stressors that come with sort of the more strict quarantine restrictions. Balancing those restrictions with — the truth of the matter is that if this virus continues to spread to communities, we're going to see more hospitalizations, increase in death again. It's unfortunately coming and we need do something here to mitigate this.

GILGER: So what do you think that mitigation should look like? Is this a policy thing? Is this just people understanding and buckling down and doing what we did over the summer?

KOHLI: You know, I think first things first. We all need to do the simplest things first that are the least restrictive. Everyone needs to wear a mask when they go out. We must engage in social distancing and avoid large gatherings of people. If we can control the virus doing those very simple things, that is the best, although it is — given the rise in cases, I am worried that something more drastic will have to take place. And, you know, I'll leave that to our leaders about sort of the decisions that need to be made. But talking about do we need to have policies around restaurants and bars and maybe even schools again? I know that's something that's being discussed every day at sort of the state and federal level, given the rise in cases. But I would say, just as a community, if everyone can act responsibly as individuals, then the less we'll have to do sort of at a more of a sort of mandate or policy level. And that would be great for everybody, I think.

GILGER: How much worse do you think this could get after the holidays as we're facing the holiday season coming up really quickly here?

KOHLI: Oh, it very easily could be much worse than where we were in the summertime, if we don't do something very, very quickly. The cases daily are very similar to where we were at sort of the height of the pandemic in Arizona and even nationally, we've already surpassed it. But here locally, if we don't act quickly, we will be far worse than where we were this summer with the surge in cases, even hospitalizations and deaths. Something will need to be done before the holiday season for sure. Again, I think sort of that individual responsibility is the first key component. And then if that doesn't stop what's going on here, there will need to be policy level changes that need to be made.

GILGER: OK, that is Dr. Anita Kohli, director of clinical research and an infectious disease specialist at Arizona Liver Health. Dr. Kohli, thank you so much for coming back on The Show.

KOHLI: Thank you for having me.

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