Dr. Bradly Bundrant is the chairman of the Health & Wellness Coalition of Runnels County. The coalition is getting ready to host health screenings, public education classes and podcasts.
It is not the flu and it is not the disease. The facts explain the confusion about the government's response to the Pandemic. The power of this virus is that it is highly contagious in people who have no symptoms.
The time when symptoms start and the time before and after the start of symptoms are the times when people are most contagious. That is not the same as the flu. The admonitions issued by our government would be very practical if this were a flu epidemic because the symptoms of the flu are usually very mild by the time the victim is very sick.
It makes sense for a person to wear a mask and stay away from other people when they are sick. It's a good idea for the people around the victim to wash their hands. Unless we are in the midst of an epidemic of a disease like the one in West Africa, it is not a good idea to live in that state. 50% or more of the patients die regardless of age or previous health status.
It is easy to think that COVID is the same as the flu. When I told people that they could be around their elderly relatives without being concerned, I remember many times. The initial reports showed that the Moderna vaccine was 100% effective in preventing severe COVID in the trials, and I was encouraged by that. I have been disappointed that my experience has taught me something else.
The vaccines help to reduce the chance of disease, but it seems to be less than a full reduction. The reduction in severe disease seems to be close to 100%. It is more likely that the person will be completely free of the disease if they are exposed. We know that they will shed a bit of virus for a short time.
An article in the journal Lancet titled "COVID-19: stigmatizing the unvaccinated is not justified" makes some of the same points. If COVID behaved like the flu, and if it continues to act as if it does, then it might be justified in being labeled unvaccinated.
The vaccines worked better at first, and we are being told that the reason for diminished effectiveness is that the concentration of antibodies declines over time. That is part of the truth. The Delta variant has a higher level of the antibody that is required for prevention than the variant that was previously prevalent. Petra Mlcochova wrote about Delta variant emergence, replication and sensitivity to neutralizing antibodies. We would expect that from a viral pathogen.
The evolution of these viruses will always favor lineages that spread more easily. The reason for the complete dominance of the Delta variant is that it is easier to spread because of the fact that COVID is changing to evade our vaccines. Delta may soon be replaced by a new variant called Omicron.
I was worried that other variations, such as the one from South Africa or the one from Brazil, would gain a foothold in this country. Delta is so successful that it has effectively excluded them from the gene pool. The reason I'm worried about Delta is that they lack the genes that make them so infectious, but they have a particular variation of the E484K that makes them able to evade most of our approved drugs and vaccines. Omicron has a lot of different variations, which has never been seen before.
Omicron is different, and its differences show up as another piece of misinformation. There is a chance for change when COVID is passed from one person to another. That is an incorrect and dangerous misunderstanding. A long-term COVID infection within one person is likely to be the cause of the Omicron collection of mutations. Someone who had a type of immunosuppression, such as HIV, might have taken at least one or more COVID vaccines. Each one of them acted as an evolutionary pressure to thin the viral population so that the only virus left after each treatment were immune to that vaccine or therapy. Omicron has several different types of rapidly spreading variant, and it has a new variant that has not been seen before in the wild: E484A.
We know that the E484K variant results in substantial or complete evasion of all of our current vaccines, and may cause diminished effectiveness of our most commonly used monoclonal antibody therapies. In the March 10, 2021, edition of the journal Cell Host & Microbe, the authors describe their efforts to predict and verify which potential E484A would be problematic. It would be similar to the E484K substitution.
The location of the spike protein on the surface of the viral particle which is responsible for COVID is also the location of all of the targets for the first generation of approved COVID therapies. There are a few different hands where the immune system can grab on. Natural immunity uses several other sites for antibodies to grab, and cellular immunity doesn't require a hand hold. Inhaled budesonide and the antidepressants fluvoxamine and fluoxetine have been found to be useful in COVID. ivermectin, hydroxychloroquine, and some antibiotics have some effectiveness, as well as zinc and melatonin and vitamins C and D.
We are fortunate to be getting new drugs that Omicron has not been exposed to. Sotrovimab is a drug. The end of the movie tells you that this is a monoclonal antibody and that you need to give it IV. It is a one-time dose that is given to people with at least one risk factor. It should be given as soon as possible and never after the 10th day. Sotrovimab attacks the evolutionarily conserved envelope of the virus instead of attacking the spike region.
The FDA has granted emergency use authorization for molnupiravir for treatment of COVID-19. The FDA's Antimicrobial Drugs Advisory Committee will discuss the application in November of 2021. The drug works by copying errors during the viral RNA replication process, which has been under investigation for years. It reduced the risk of hospitalization by 50% in the trial. The placebo group had 8 deaths, compared to the molnupiravir group's zero deaths. The dose is twice daily for 5 days. Pfizer has developed a new drug combination called Paxlovid, which consists of a new drug and an older drug used in HIV treatment. The company wants an EUA as soon as possible. Paxlovid was found to reduce the risk of hospitalization by 89% when compared to placebo, and was given twice a day. There were no deaths reported in patients who received the drug, as compared to 10 deaths in patients who received placebo. Paxlovid is similar to molnupiravir in that it prevents the necessary cleavage of the proteins after they are produced under the direction of viral RNA.
I think that we have begun to understand that every form of refuge has its price, and that masks still work, and so does staying entirely away from other people. There are some really good masks available now. The BYD CARE N-95 is available in a pack of 20 for $19.95 on Amazon. I advise you to have one mask for every day of the week, and put it in a paper bag at the end of the day. You can use these 7 for 2 months if you don't let them get dirty. If the mask is clean and dry, the virus will not be viable. Throw the masks away if they become wet or dirty.
I hope you find some positives in this piece. I will let you know about some good things happening in our county next week. Any views expressed are my own, and do not represent any organization I am affiliated with.
Dr. Bradly Bundrant is a physician at Ballinger Memorial Hospital and the chairman of the Health & Wellness Coalition for Runnels County.
This article was originally published on the Runnels County Register.
