How will the COVID pandemic end?

In an extraordinary 20 months, science has tackled the SARS-CoV-2 virus and made vaccines for adults and children. Scientists have developed monoclonal antibodies that help if given early; we now have the first drugs that could stop infections or tilt the immunological fight in favor of the patient. The number of COVID cases is going down, although in some areas like the mountain West the disease is still raging. The virus is an opportunist. Remember the 750,000 people in the United States and the millions around the world who have died.

People go without vaccines for various reasons that we know by now. People who refuse vaccines may not understand that “Fortune favors the prepared immune system,” to paraphrase Louis Pasteur’s “Fortune favors the prepared mind.” A 50-microgram injection induces antibodies that neutralize the SARS-CoV-2 coronavirus or T-cells that kill the human cells, which contain multiplying virus.  As the vaccines’ protection wanes over six months, a few elderly people in their 80s or older have died of COVID infections. The late waning can be corrected by boosters, or at least I hope so.

The grizzly experiment to test the SARS-CoV-2 vaccines has been done in Texas, Florida, Louisiana and other places where the level of vaccination is low. The virus, or more recently the delta variant, raced through the population, filling wards with COVID patients. A year-and-a-half after this disaster hit New York hospitals, other hospitals in the West and South, Alaska and other places are converting space to treating COVID-19 patients. More than 90% of their patients in intensive care were not vaccinated. Anti-vaxxers do not usually plan clinical trials, but in this case, inadvertently, they did. The vaccine protects people.

Predicting the end of the pandemic is a tricky business. We thought we had seen the end in June and July. Then, with the delta variants, the trend reversed among unvaccinated people and cases went up. Could there be more variants? Yes, but so far, the vaccines have worked against all variants. Antibodies and T-cells react with all parts of a virus protein, not just the sections that have changed in the variants.

What does medicine have to throw into this battle?  Monoclonal antibodies are being used and they work if applied early in the disease. These antibodies are produced in fermenters and must be infused intravenously. They are expensive and tricky to use. Fighting an epidemic, especially in poor areas of the world and of the United States, demands simplicity.

There is a drug, malnupiravir, that if given early in an infection often controls it. It was developed at Emory University in Atlanta and licensed to Merck for production. Malnupiravir is a cleverly designed molecule that gets incorporated into new viruses and mutates them out of existence.  It has been approved for use in the United Kingdom. It may block infection in people who have been exposed to the virus. That will be known soon. Merck will not enforce patent restrictions.

Pfizer also has a promising drug that works by a mechanism that is different from that of malnupiravir. The difference is important because viruses often mutate to become resistant to one oral drug. In the case of HIV, several drugs were required to stop infection. Pfizer’s drug is also well along in phase 3 clinical trials and may soon receive an Emergency Use Authorization.

Excited journalists are writing about these drugs as game changers, but that is premature. A drug or combinations of drugs must have changed the game to be called a game changer. On a population basis, that remains to be seen. I am hopeful, but a little caution is in order. On a more hopeful note, drugs like these have worked for HIV, Hepatis C virus, and Dengue virus. Producing and distributing these drugs for the whole world will take time.

My prediction is that COVID-19 will recede in areas of high vaccination. All treatments will have a role, but vaccination will play the primary one. In areas where vaccination rates are low, say 40%, there will be serious problems with high levels of infection and overwhelmed medical facilities for extended periods. That patient load affects a hospital’s ability to treat other diseases. The poor and medically underserved will get even less attention. Schools, industry, and the economy are weakened. Society becomes very cranky, even violent. The vaccines, and perhaps the drugs, offer an off ramp from this disaster.

Richard Kessin lives in Norfolk and is Emeritus Professor of Pathology and Cell Biology at the Columbia University Irving Medical Center. See other essays at RichardKessin.com or at The Lakeville Journal. www.tricornernews.com/category/opinion-author/body-scientific. E-mail: Richard.Kessin@gmail.com.

The views expressed here are not necessarily those of The Lakeville Journal and The Journal does not support or oppose candidates for public office.

Latest News

Senator Murphy starts statewide walk in Northwest Corner

U.S. Sen. Chris Murphy walks through Sharon on the first day of his annual statewide walk.

Photo by Ruth Epstein

Decked out in a blue T-shirt, khaki shorts and a UConn cap, the man walking along Route 41 in Sharon Wednesday morning looked like others who just enjoy getting out to commune with nature. But U. S. Sen. Chris Murphy (D) had some other thoughts on his mind.

For the ninth year, he was walking across Connecticut to connect with citizens of the state. This year’s route began May 28 in Salisbury and took him to Sharon and Kent for the day.

Keep ReadingShow less
Marion J. Pedersen

SHARON — Marion J. (Cookingham) Pedersen of Sharon, passed peacefully on May 20, 2025, at the age of 91.

Born in Pine Plains, New York, she lived a life of love and unwavering strength. She was a devoted mother, grandmother, great-grandmother and wife known for her cooking skills.

Keep ReadingShow less
Eleanor Sternlof

LIME ROCK — Eleanor Anne Sternlof (née de Guise) of White Hollow Road passed away on April 25, 2025 at Geer Village in North Canaan, Connecticut. She was 94 and the loving wife of the late Paul William Sternlof, who died on August 12, 2005.

Calling hours will be held on Saturday, May 31, from 11am to 1pm at The Kenny Funeral Home, 41 Main Street, Sharon, CT.

Keep ReadingShow less
Jacqueline Irene Dirck

SHARON — Jacqueline Irene Dirck, affectionately known as Jackie, passed away peacefully on May 20, 2025, in Phoenix, Arizona, at the age of 84. Born on Nov. 19, 1940, in Joplin, Missouri, Jackie lived a life filled with warmth, laughter, and deep devotion to those she loved.

Jackie shared an extraordinary 62-year marriage with her high school sweetheart and beloved husband, Ronald Dirck. Their enduring partnership was a shining example of lifelong love and unwavering support. Together they created a home that radiated joy, a gathering place for family celebrations marked by spirited card games, hearty meals, and heartfelt conversations. Jackie especially treasured quiet afternoons spent with a cocktail in hand, embracing life’s simple pleasures with grace and good cheer.

Keep ReadingShow less