COVID, Quickly, Episode 2: Lessons from a Pandemic Year

By Tanya Lewis, Josh Fischman, Jeffery DelViscio & Sunya Bhutta

Tanya Lewis: Hi, and welcome to COVID, Quickly, a new Scientific American podcast series!

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

Tanya Lewis: I’m Tanya Lewis.

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Josh Fischman: I’m Josh Fischman.

Tanya Lewis: And we’re Scientific American’s senior health editors. Today, after a whole awful year of COVID, we’re going to talk about what we did wrong and what we’ve learned to do right. We’ll also be correcting an idea that the new Johnson & Johnson vaccine is second-rate and giving you news about some recent developments in COVID medicines.

Josh Fischman: This isn’t a celebration kind of anniversary, but we’re at the one-year milestone of the pandemic. 

Tanya Lewis: This week is the one-year anniversary of when the World Health Organization first called COVID a pandemic. This time last year, the world was going into lockdowns, borders were closing, and cities became ghost towns. Now, we’ve lost more than 2.6 million people worldwide to this awful disease, including more than half a million in the U.S.

I wrote a story about some of the biggest mistakes in the U.S. pandemic response, from not taking the virus seriously to confusing or inaccurate mask guidance to failing to protect our most vulnerable people—whether it’s the elderly, essential workers or people of color. These mistakes cost hundreds of thousands of lives.

Josh Fischman: It’s been such a tragedy. Has it only been disaster after disaster?

Tanya Lewis: There were some successes, too: Health care workers stepped up to treat people the best they could. Everyday people took initiative to help flatten the curve. But perhaps most impressive of all: several highly effective vaccines were developed in record time. And they all protect against severe disease and death. And now millions of people are getting vaccinated every day all across the country. In fact, we’re already seeing dramatic declines in the numbers of elderly people hospitalized and dying from COVID in the U.S., which is at least in part due to the vaccines. You can read more about the biggest lessons from a year of the pandemic in my story on ScientificAmerican.com.

Josh, not everyone is totally excited about the Johnson & Johnson vaccine. What’s up with that?

Josh Fischman: People are paying a lot of attention to one number from the vaccine trials: 23. Overall the Moderna/Pfizer vaccines seemed 23 percent more effective than the J&J one, which protects at about 72 percent. So some people—like the mayor of Detroit last week, who at first passed on using J&J in his city but changed his mind—seem to think J&J isn’t as good.

But here’s why 23 is misleading. It’s probably much smaller in real life. The first vaccines were tested early last year, when there wasn’t a lot of virus around. The J&J version was tested in late fall, when there was a lot. A lot means, naturally, more people get sick. If Pfizer/Moderna was tested now, more people in those tests would get exposed, and the vaccine would show a smaller improvement than 23. Plus, we know J&J works against some of the new virus variants because it was tested after they appeared.

And J&J prevented 100 percent of hospitalizations and deaths and 85 percent of severe illness. That’s what you want in a vaccine in the middle of a deadly pandemic—to keep you from needing an ambulance ride to the ICU.

Tanya Lewis: Good point. But what about drugs to treat you if you already have the disease? That’s a different story and sometimes a frustrating one, right?

Josh Fischman: Yep. There are not a lot of approved drug options for COVID. It’s been a year, and we’ve got the drug remdesivir and two forms of monoclonal antibodies to slow down the virus in your body. They work a bit, but the effects are not major. And there’s the steroid dexamethasone, which helps hospitalized patients who need oxygen or are on ventilators. There’s not a lot else in the medicine cabinet.

Tanya Lewis: Do you know of anything new in the works?

Josh Fischman: Well, an NIH treatment panel recently approved another monoclonal antibody drug, tocilizumab, for hospitalized patients who are having real trouble breathing. The drug damps down inflammation—that’s what’s behind the breathing distress. But I talked with Lindsey Baden, an infectious disease doctor at Brigham and Women’s Hospital in Boston, who said the drug only works in patients who also get dexamethasone. So you still need both. He sounded a bit frustrated that there was not a clearer benefit to the drug.

And other researchers share this frustration. Some are calling on the Biden administration to start supporting medicine development the way it supports vaccines. Biden did just sign an executive order telling the federal government to come up with a plan to test more medicines. That seems like a step in the right direction.
 
Tanya Lewis: Now you’re up to speed. Thanks for joining us. 

Josh Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.