(CNN) — Three years have passed since the first case of COVID-19 was diagnosed in the United States on January 20, 2020. Since then, nearly 1.1 million Americans have died from the coronavirus; According to Johns Hopkins University, the United States has reported 102 million cases of Covid, more than any other country. Many health officials believe both figures are underestimates.
There have also been remarkable scientific achievements in our response to the pandemic, notably the development of vaccines against COVID-19. But there are still many unanswered questions. To help reflect on what we’ve learned and what we need to understand more, I spoke with CNN medical analyst Dr. Lena Wayne, an ER physician, public health specialist, and professor of health policy and management at the school. from The George Washington University Milken Institute. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health”.
CNN: You’re a physician who cares for patients, a public health researcher and a professor. What are the key lessons you have learned from the last three years of Covid-19?
wear and tear Leena Wins: There are three main lessons that come to mind. First, we have seen how much the global scientific community has come together and made some truly incredible achievements. Less than a year after Covid-19 was declared a pandemic, we had a vaccine developed, licensed and distributed. The scientific community has become involved in many other aspects of the response to COVID-19, including identifying treatments and improving surveillance testing.
Many of the scientific advances will live beyond this pandemic and help other aspects of our response to infectious diseases. For example, the technology behind mRNA vaccines can be used to create vaccines for other diseases. The wastewater monitoring used to identify and track COVID-19 may be useful in detecting other viruses.
Second, COVID-19 has exposed many existing crises and magnified them for the world to see. The coronavirus did not create health inequalities that existed before the virus, but it exacerbated existing ones.
There were also many lapses in the public health infrastructure, while those of us in the field who have known about them for a long time have been exposed for all to see. Data systems are not unified among public health agencies, for example, and city and county health departments are woefully underfunded because of their multiple responsibilities. These stem from the fragmented health care system in the United States as well as a continued lack of investment in local public health agencies.
At the same time, COVID-19 has also demonstrated how important public health is. There is a saying that “public health saved your life today, you don’t know it”. I think many people recognize that public health is necessary to prevent problems that can have a major impact on people’s health and well-being.
That being said, Covid-19 happened at a time of deep division. Nearly every aspect of the pandemic has been politicized and polarized. So third, there has been rampant misinformation and misinformation that has made the response that much more challenging. We are seeing lasting effects, such as reduced acceptance of routine childhood vaccinations. I am deeply concerned that public health has become politicized in a way that could undermine our response to future pandemics.
CNN: You mentioned that we’ve learned a lot scientifically. What else do we need to understand about COVID-19?
Wayne: At this point in the pandemic, many people have put COVID-19 behind them and no longer see it as a major factor in their daily lives. Yet millions of Americans are vulnerable to serious illness who are deeply concerned about the coronavirus. These are people who are immunocompromised, elderly or have multiple underlying diseases. For me, the most important research questions pertain to these individuals.
There are some antiviral drugs that are effective for treating COVID-19, such as paxlovid. However, some patients are not eligible for Paxlovid and other options are becoming more limited. The US Food and Drug Administration (FDA) has revoked its authorization for monoclonal antibodies that could treat COVID-19 infection, as they no longer appear to be effective against the new circulating variant. The FDA also recently stated that Evushheld preventive antibodies may be ineffective against certain variants, including the XBB.1.5 variant that is currently dominant in the United States.
An urgent priority should be to focus on developing better treatments for those most vulnerable to serious illness from COVID-19. I also hope that more investment will be made in finding better vaccines. The vaccines we have are very good at protecting against serious diseases, which is the most important thing. However, they are not very effective at preventing infection.
The ideal vaccine would be more effective at reducing infection and attack the virus more broadly so that we don’t always have to try to predict which variant will develop, and then find a vaccine that works against that variant at hand. – They’re kicking. For example, nasal vaccines and pan-coronavirus vaccines are being researched. I hope these efforts will gain momentum.
CNN: We’re learning more about Long Covid, but is this an area that needs more research?
Wayne: Absolutely. We know that many people have persistent symptoms after infection with COVID-19. According to a large study from Israel, most symptoms resolve within the first year after infection in people with mild disease. However, there are some who have long-lasting symptoms, such as fatigue, headache, palpitations and shortness of breath, that are so debilitating that they can no longer work.
There are many things we still don’t know about Long Covid. The most important thing is how to treat patients suffering from it. The physiological mechanisms behind these persistent symptoms are also unclear, nor are how common they are.
Longer wait times to get to the specialty clinics that treat the condition today require a lot more education for primary care physicians and other doctors, who will likely become the primary healthcare providers for many long-term sufferers. .
CNN: What do you anticipate happening next year around COVID-19?
Wayne: Right now, China is experiencing a huge increase in cases. It is the last major country to implement strict zero covid policy and now that policy has been reversed. Once China’s infection numbers stabilize, COVID-19 will likely become endemic there, as it has been in most other parts of the world.
New forms will no doubt emerge. We need to be aware of them and monitor them accordingly to see if they become more lethal and/or evade the effectiveness of existing vaccines. The key, as I said earlier, is to develop vaccines that can cover variants more broadly.
And we must again remember that while many have resumed their pre-pandemic lives, others have not. In the coming year of COVID-19, I feel there is a need to focus more on these people who need our help the most. We must extend reinforcement and healing to the most vulnerable, for example.
Finally, there must be a much greater effort to rebuild our public health infrastructure. It is overdue. Doing so is critical not only to prepare for the next pandemic, but also to improve the health and well-being of all Americans.