Five Months In: Dr. Robert Amler Shares The Latest Info

Three vaccines entered phase three trials at the end of July. What are the next steps on that—what it will take to find one that works and get it to distributed to the public?

The goal is a vaccine that is safe and effective for use in most population groups, one that has few side effects and achieves a satisfactory level of acceptance by the public. That’s easier said than done! The timeline so far is actually remarkable. Three vaccines are already in phase-three trials after only a few months of work. But nothing is certain until the right vaccine characteristics are demonstrated objectively to a wide audience of observers.

As we go into cold and flu season what does this mean for COVID? How will people know the difference between COVID and the flu? Will the flu shot help?

Get that flu shot, without a doubt, to avoid the “diagnostic confusion” when the “regular” flu could give you COVID-like symptoms that worry everyone around you. With COVID still out there, the flu shot is a must. During the SARS epidemic 10 years ago, many millions lined up for their first flu shots, for the same reason.

Do you expect to see the much-talked about second wave this winter? 

The virus is continuing to spread so we can expect that a second wave will be an ongoing threat. How much more damage it causes will depend largely on our actions to block COVID exposures, and better treat COVID infections when they occur. Fortunately, both types of actions are gradually becoming more effective.  We can and will get through this.

Does you think by mid to end of 2021 life will start to look more normal?

This depends on the virus, but also on all of us. The virus will infect as many people as it can. But our actions to block exposure will continue to reduce risks, and our growing familiarity and comfort with all the novel preventive measures will become more routine and make life seem more tolerable as time passes.

What about back-to-school for school-age kids—how do we stay safe, should schools be open, in your opinion?

School-age children are worth every extra effort that we can muster. They are literally our future and must continue to grow academically as well as socially and emotionally. Their working parents need support as well, so life can proceed as “normally” as possible. It’s plain reality that reopening schools safely is the BIG JOB that we MUST DO. Sending our children safely back to school, while protecting teachers and staff as much as possible, should be one of our highest priorities in fighting COVID. We should employ every ounce of our innovative abilities to do this and do it well.

It seems like corona cases are rising but deaths are decreasing. How far has treatment of corona come since the pandemic started?

A number of important lessons have been learned but the COVID-19 virus continues to surprise us. Although it presents as respiratory, it affects more than just the lungs. In many cases, people who die after contracting coronavirus are dying from its effects, such as blood clots in the brain. Coronavirus weakens the heart muscle. We now know that treatment is not just about putting people on ventilators.

Also, if you look at the numbers, statistically there are more cases but we now have a much broader base of testing, so many more people are getting tested. The more you look, the more you find. At one point, the CDC estimated that there were actually 10X more cases than what was being reported.

We do have more efficient reporting for deaths and hospitalizations due to COVID-19, as those events are much easier to track. We know the number of deaths has risen more slowly than number of cases. We have come farther along in treating and in recognizing complications before they become irreversible. Also, people at greater risk of COVID-19 understand what’s at play and probably many are being more careful. Everyone who is older, obese, has high blood pressure or diabetes needs to follow all recommended precautions. Regardless of your personal situation, bear in mind that COVID-19 spreads like a cold. If you protect against exposure, you can reduce risk.

One third of Americans said they wouldn’t take the new vaccine. How then will we reach immunity?

It’s going to be a question of how much people want to protect against disease vs. not wanting to take a vaccine. When SARS first hit in ’02-’04, more people got flu shots than ever before. If the threat is perceived as real enough, people will get vaccinated. The pathway to getting the COVID vaccine is going to be longer because it has to be safety–tested. No one knows when a safe and effective vaccine will become available.

Before we give vaccines to healthy people, we must make sure that the benefit outweighs the risk—when the chickenpox vaccine first came out, there was hesitancy of using it except for family members of children with cancer because their kids could otherwise die of chickenpox if exposed. These family members didn’t want to get infected and transmit it to their kids. The vaccine proved to be very effective and safe, and after a few years it was given to the general population of kids.

Most scientists are saying that herd immunity is not really possible, as it seems antibodies only last for a few months. So, if immunity can't be achieved then how do we move on? Will a vaccine even work?

We simply don’t know. If immunity is short-lived, we will not be able to depend on herd immunity. Right now, we don’t know how long immunity lasts, or if the level of immunity is different based on the severity of infection you had. Whatever immunity you are shown to have when we test you, we don’t know how protective that is. However, there are some very large scale studies looking at immunity of thousands of people who’ve had the virus—whether they hardly knew they were sick or had a very tough case. The study is testing the antibodies themselves to see if they’re effective in neutralizing the virus in the lab. There are great scientific minds working on this and large drug companies putting lots of funds into developing treatments.

What do you recommend for the average person to minimize risk?

While I remain hopeful that these efforts will yield results, right now I recommend that each of us should continue to minimize risk by blocking exposure. I recommend the 4 W’s—wash your hands, wear a mask, watch your distance and walk away—don’t stay in the same space for too long. If you’re shopping, even with the first three W’s in place to protect you, get what you need and then walk out as soon as possible.