In two respects, I may have been wrong—too pessimistic—in my analysis of the five strategic stages of our war with Covid-19. News reported on PBS within the last week or so, but not yet (to my knowledge) picked up by the print media, suggests two new ways in which to fight the war more effectively.
1. A belated all-out push for active-virus testing.
My own analysis suggested that the United States already has missed the boat on this sort of testing with its late, slow and incompetent start, so that massive active-virus testing is no longer of general strategic value. But two very smart and well-qualified experts, Paul Romer and Rajiv Shah, believe the contrary. They propose that, for an investment of $100 billion per year (a fraction of what we’ve already spent on stimulus), we could jump-start active-virus testing and use it as a safe and effective means to open parts of our society, and maybe eventually all of it, back up for business. They suggest doing this even before we try doing something similar with antibody testing in search for acquired immunity (what I call “Stage Three” in our war).
So far, our federal management of testing in general has revealed all the earmarks of extreme incompetence at the highest level. In active-virus (infection) testing, the FDA and CDC were classic “control freaks,” refusing to authorize anyone else to develop tests until it was too late to contain severe initial outbreaks all over our nation. With respect to antibody-testing—a second-line defense—the regulatory agencies adopted exactly the opposite approach. They allowed some 90 different companies, many in China, to sell tests in the US without any verification of their accuracy, and many of them simply didn’t work.
This oscillation from one ineffective extreme to the other is a classic symptom of leadership that doesn’t know what it’s doing. But with better leadership, perhaps from the private or philanthropic sector, the Romer-Shah plan might still work.
2. Spurring “innate” immunity.
The second ray of hope is the use of a common vaccine, already in wide use, to spur a type of temporary immunity, called “innate” immunity, that can be provoked before infected patients can develop antibodies (which typically takes two to several weeks). Science initially discovered in Russia suggests that a common oral polio vaccine can trigger this sort of immunity against influenza—another coronavirus. No less an authority than Dr. Robert Gallo, co-discoverer of HIV, the AIDS virus, thinks this same approach might work with Covid-19. The approach would be simple and cheap to test.
“Innate” immunity is thought to be temporary, lasting an unknown time, perhaps a month or so, while patients’ bodies develop antibodies and longer-lasting acquired immunity. Beyond that, not much is known about innate immunity, including whether it can be repeated in the same patient.
So it’s not a panacea, even if it works against SARS-CoV-2, the Covid-19 virus. But it could have three possible uses. It could help: (1) immunize people temporarily for such high-risk activities as (a) moving to another city or state, (b) temporary high-risk front-line work for medical personnel, or (c) other time-limited, high-risk work such as disinfecting a physical complex, cleaning out a heavily infected nursing home, slum or apartment complex, etc.; (2) immunize people temporarily while a vaccine under test let them build up longer-lasting antibodies; or (3) perhaps even serve to ameliorate the disease after accidental or deliberate exposure, for example, in “challenge” testing of a candidate for a vaccine.
It remains to be seen whether our Keystone Kops society, in which neglect, wishful thinking, indecision, useless ideology and general incompetence have become ways of life, can effectively exploit these rays of hope. But at least we have them. Both appear worth trying. Thank to Christiane Amanpour of PBS for bringing them to light. |