I spent much of my clinical social work career being the social worker for a major tertiary regional medical center’s HIV/AIDS program. Having the opportunity to work with Infectious Disease Specialists and HIVologist physicians and nurse practitioners as well as attending both physician centric and social work centric seminars I learned alot about the pathophysiology of the HIV virus. And I began to think about how this knowledge would apply to other viral pathogens. I began my work with HIV/AIDS before there were ANY anti-retrovirals . I then remember the first slight opening of the door with the FDA approval of first AZT and then d4T. These were the first drugs which could suppress HIV growth in the human body but in a sense these drugs were a pyrhric victory given their toxicity and severe and severe side effect profile as well as the need for extremely demanding dosing schedule and the frequency of viral mutation that would render the drug ineffective. But it was the first weapon that medicine had to potentially control HIV. Fast forward ten or so years and Infectious Disease medicine had a greater understanding of how HIV penetrated immune cells, took control of their reproductive machinery , and turn a healthy cell into a virus producing machine. Understanding that there were at least 5 points in the life cycle of an HIV virus that viral replication could be stopped and with this knowledge a whole new theory of HIV virus control could be created. The new age of HAART (Highly Effective Anti Retroviral Treatment) was then able to dawn. Researchers began to look for new compounds which could be targeted at each of the five points and began combining these new compounds into anti-Retroviral medications that could attack attack HIV at three different points in its reproductive cycle so as to literally stop HIV viruses from taking control of CD 4/T cell lymphocytes and turning them into HIV Virus producing machines. And as HIV drug development continued a whole new family of medications from companies like AbbVie and Gilead combined different compounds to develop anti Retrovirals that each had a different combination of attack points to prevent HIV replication such that if a patient’s HIV virus became resistant to one three compound medication then another three compound medication could be prescribed which attacks the HIV virus at a different combination of viral replication points. And Big Pharma has continued to create more and more effective anti-HIV medications with fewer side effects, a smart size pill to make swallowing easier for the patient, and once or twice a day dosing to allow an HIV Positive patient with a zero viral load meaning that the disease cannot progress and the patient stops being infectious can now have a “normal” life, a life which is not ruled by a dosing clock of pills having to be taken at odd times, 3,4 ,5 6 or more times day, or not ruled by special dietary restrictions or not rules by having to plan around dealing with unpleasant side effects. In fact there are currently multiple Anti-Retrovirals that are FDA approved for HIV Negative individuals to take daily to prevent becoming infected if exposed to the HIV Retrovirus. A disease that not long ago could not be controlled and could lead to death and for which there was no prevention strategies except for avoiding infected persons or using barrier protection can now be managed in the infected person so that they can live a pretty much “normal” life and can be NOT infectious as long as they are taking the appropriate medication(s) or combination medication(s) and the non-infected person can be protected from becoming infected by taking one of the FDA pre-exposure prophylaxis medications by taking one pill a day. The only let down is that despite extensive research, NO preventative vaccine has been discovered.
You may say “what does this have to do with me?” I would like to submit that this same strategy should be used to create a treatment protocol to treat COVID-19 and control it in the body of an infected person and render the virus unable to be transmitted to another person. Gilead’s discovery of Retonovir as part of a combined medication mediated treatment of acute and infectious COVID 19 is a very early step, somewhat akin to the initial therapeutic use of AZT to attempt to treat the 1980’s HIV patient. Even with addition of antibodies created by an infected person to defeat COVID-19 that have been harvested and made into a serum to fight COVID in an infected patient and with steroids to suppress a cytokine storm, the battle to defeat COVID in a patient’s body is a challenge and there is no assurance that the virus will be defeated and the patient cured. It seems to me that medical researchers need to be looking for different medications to attack and defeat the COVID virus at each point where it attacks and takes over healthy tissues and turns the invaded cell into a COVID making machine. This would include compounds that prevent the spikes of the COVID virus from attaching to a healthy cell, puncturing the cell membrane and then invading the healthy cell taking over its DNA in order for the virus to replicate into multiple viruses with the design to take over the host’s body and then spread the virus to other humans. As great of a development as the discovery of a 95% effective vaccine, it would seem that having a curative medication or medication protocol remains essential since there remains the 5% chance that a vaccine will not work on certain people, there is the possibility that not every person in the world will be protected by vaccination, there is the possibility of genetic mutations in a selected variant of the COVID could mutate rendering the vaccine ineffective and allowing virus to survive and thrive, and there is the possibility that this ineffectiveness rate could be higher in some of the different (at current count 10) vaccines being developed putting even some vaccinated persons at risk.
It is my belief that to defeat COVID 19 and to open the door to treatment of other Carona Virus mediated illnesses a multi compound Highly Effective Anti Carona Virus Treatment medication needs to be discovered and placed into the medication based toolbox that physicians have to COVID 19 in parallel with the creation of multiple effective vaccines that can be manufactured and distributed around the world for innoculation of EVERY person with an emphasis to discover easier to use and handle compounds.