Op-Ed: Deaths continue during a bungled COVID vaccine rollout; Can the new administration prevent the next 200,000 deaths? | Dr. Rajesh Mohan

Yes! Of course, we can.

Amidst the clangor of the botched COVID-19 vaccine rollout, there appears to be little interest to learn from the over 380,000 lives lost to the pandemic, let alone try to prevent the additional about 200,000 lives projected to be lost by April 2021. We have a vaccine. However, a singular focus on vaccines, the distribution of which is stumbling through bureaucratic nightmares, being the panacea is disingenuous. There is nothing that should preclude us from attacking this pandemic on multiple fronts. In fact, that is how we should have started in early 2020. We are making a similar mistake now in early 2021 by not utilizing all resources.

While I am hopeful about the vaccine, I cannot help but be taken back to March 2020 when COVID-19 was declared a national emergency. What followed was a collective cacophony overemphasizing the importance of ventilators at the cost of personal protective equipment (PPE), N95 masks, and COVID-19 tests. The number of deaths caused by the unavailability of ventilators paled in comparison to the lives lost due to the unavailability of tests and a coherent strategy to combat the pandemic.

The incoming government’s attitude and approach toward the pandemic stand in stark contrast to the outgoing one. Indeed, President-elect Biden promises 100 million vaccines in 100 days. That alone is not going to help in a manner that we all wish it would. It is obvious that everyone does not consume information the same way nor do they arrive at similar, let alone same, conclusions. Case in point: masks and physical distancing.  Sadly, yet accurately, the country seems nearly equally divided on the merits of wearing masks and physical distancing. Similarly, a significant percentage is skeptical about receiving the vaccine. Thus, it may be wishful thinking to presume that changing the messenger alone will decrease preventable deaths.

Even if a significant percentage of Americans agree to be vaccinated, it could take approximately 6 months. The second surge is already worse than the first. Deaths and destruction of livelihoods should be prevented in the next 6 months and until herd immunity is achieved by vaccination.

The following is what needs to be done in the meantime:

First, the Defense Authorization Act should be enforced to increase production of all tools necessary in the fight against COVID-19. Many hospitals are still reprocessing N95 masks. There must be abundant availability of PPE, N95 masks, COVID-19 tests, COVID-19 antibody tests, contact tracing, and therapeutics, including monoclonal antibodies.

Second, there should be easy availability of all therapeutics, including monoclonal antibodies that have been approved under the Emergency Use Authorization (EUA) for outpatient treatment. Eli Lily’s Bamlanivimab and Regeneron’s cocktail of Casirivimab and Indevimab are outpatient treatments for patients with COVID-19 who are not sick enough to be admitted to a hospital. They were available for President Donald Trump, Governor Chris Christie, and others. Patients who receive these would recover at home and not be admitted to hospitals, barring some. This would be a win-win for patient care and building confidence in communities while preventing the overwhelming of hospitals.

Third, patients should be advised to seek early instead of late medical attention. I have been pleading since March 2020 that public officials and administrators reverse their recommendation and change it to early rather than late treatment strategy. So far, public officials and administrators have been more concerned about hospital well-being rather than patient well-being. The reason why patients are being advised to stay home and not seek early medical attention until they are severely sick, is to avoid overwhelming hospitals. The basic dictum of primary prevention, early recognition, and early management of disease – the way medicine is supposed to be practiced is not being followed. These asymptomatic, mildly, and moderately symptomatic patients thus continue to spread the virus to family members and members of their community. It is this rapid, non-linear, and uncontrolled spread of COVID-19 that is overwhelming hospitals. The current recommendations have been counterproductive. Patients should get the care they need promptly, and not wait until they are close to dying and need hospitalization. Easy availability and early use of monoclonal antibodies should be an integral part of this strategy.

Fourth, once the goodwill and trust of people is earned, commonsense measures like masking, physical distancing, and hand washing will be more readily accepted.

Fifth, with the adoption of these measures, lives and livelihoods will be saved. The U.S. economy would rebound, and people would get back to work and restart living their lives – with the vaccine being a timely blessing.

It would be profoundly tragic if we just sit back and wait for the vaccination of 70 to 85 percent of Americans over the next 6 months (which may or may not happen), while repeating the message of masking and physical distancing that has thus far fallen on many deaf ears. Another 200,000 Americans may die, and thousands of jobs would be lost.

In a civilized society, it must not just be survival of the fittest. We can take care of the present as well as the future.

The opinions expressed by Dr. Mohan are solely his and do not represent those of any individual, group, entity or organization that he is currently or was previously associated with.


Dr. Mohan’s new book, COVIDSLAYERS, an enlightening work that shows the inner working of the healthcare system as it navigated the early days of the coronavirus pandemic, can be purchased by clicking here


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