The COVID-19 pandemic has been overwhelming, not only in terms of the huge numbers of people who have gotten sick or died. We have also been engulfed with information about the virus, the infection, the risk factors, what we should do and what we can expect. Much of this information has been contradictory. We turn to a leading expert in digital medicine and technology to find out how we can start learning lessons from the pandemic.
With enormous variability in case rates around the world, predicting the future spread is a challenge. We discuss regional differences and the controversy over vaccination vs. “natural” immunity. The only way to gain natural immunity is to recover from COVID, but the course of the disease is far from predictable. That’s why we asked about boosters: who benefits the most? How important are they? Is it ethical for older people in wealthy countries to get booster shots when so many people in the world have not yet had their first? Ethics aside, why do world vaccination rates matter to people in the US?
Merck has asked the FDA to grant its new antiviral molnupiravir emergency use authorization. This pill could be taken at the first hint of infection. If taken early, it can reduce the rate of hospitalization by 50%. In the trial, nearly 15% of those on placebo needed hospital care for their COVID infections. Just over 7% of those taking molnupiravir ended up in the hospital for their infection.
Dr. Topol discussed the cost of molnupiravir with us. Merck is making the formula available to drug makers in low-income countries without royalties. That is commendable. In the US and probably in the UK and Europe, however, the drug is likely to cost a pretty penny.
Even in our age of artificial intelligence and elegant digital technology, many of us have been learning lessons from a previous pandemic. Steps taken during the 1918 flu pandemic have proven to be some of the most effective against COVID-19 as well: good masks, stringent distancing, effective ventilation.
Why are we so far behind the curve when it comes to learning lessons from the pandemic? We need good data collection and unbiased analysis. Public health measures need muscle. How will we prepare for the next pandemic, which is more a matter of when than if?
Dr. Eric Topol is the Founder and Director of the Scripps Research Translational Institute and Professor of Molecular Medicine. He is the Executive Vice-President of Scripps Research and holds the Gary and Mary West Endowed Chair of Innovative Medicine. As a researcher, he has published over 1,200 peer-reviewed articles, with more than 250,000 citations. Dr. Topol was elected to the National Academy of Medicine and is one of the top 10 most cited researchers in medicine. His principal scientific focus has been on genomic and digital tools to individualize medicine.
Dr.Topol is the author of several books. His most recent book is Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.
You can find him on Twitter @EricTopol. The photo of Dr. Topol is by Michael Balderas.
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