Needed: An ‘All of the Above’ Covid Approach

Globalization has been mostly plusses, but the rapid spread of the coronavirus last year has illustrated an enormous minus: humans are not the only species that’s hyperconnected anymore, viruses are too. This is going to be an ongoing war between humans and viruses, and Americans need to find the best practices for the future.

We are not going to benefit a one-dimension strategy of vaccinating our way out of this and every pandemic to solve the economic and health impact of viruses. Realistic solutions include an “all of the above” long-term strategy that incorporates vaccines and therapeutics.

On Nov. 9, Merck, in partnership with Ridgeback Biotherapeutics, announced that the U.S. government would be purchasing 1.4 million additional courses of its experimental Covid-19 treatment molnupiravir. This is good news, and signals that the Biden administration may be shifting from a “vaccination at all costs” strategy to one that is broader, more realistic, and acknowledges the unfortunate truth that we are going to be living with the threat of this and future pandemics for the long haul.

A world that’s both hyper-connected and free from communicable diseases is not a reality, and the federal government should be devoting critical resources towards investigating longer-term therapeutics that treat patients suffering from Covid-19, irrespective of their vaccination status. Vaccines can play an important role, but the administration cannot limit itself to a one-dimensional strategy to fight and contain the virus; the molnupiravir announcement appears to demonstrate that it understands this.

And while government support is critical for the investigation of novel therapies, the repurposing of existing drugs in the fight against the pandemic is an equally worthwhile endeavor that has already yielded significant benefit. Gilead’s remdesivir – the first Covid-19 treatment to gain approval from the U.S. Food and Drug Administration (FDA) – was originally a hepatitis drug that was later modified for the treatment of Ebola. It is now part of the standard of care, together with dexamethasone, for patients hospitalized with Covid-19.

Other treatments are also currently being investigated. For example, Rigel Pharmaceuticals’ fostamatinib, originally approved by the FDA for the treatment of chronic immune thrombocytopenia, is currently undergoing phase III trials as an immunoregulator for Covid-19, a drug that is able to throttle the body’s response to infection and reduce the need for oxygen and ventilation in hospitalized patients.

Vaccines and therapeutics together, as part of an “all of the above” approach, make sense as part of a comprehensive, government-supported strategy to realistically battle the virus. While the constant messaging to Americans from Washington and Big Pharma is to get vaccinated, vaccination alone will not rid us of Covid-19. We know that breakthrough cases and variants are thwarting the vaccination strategy; the data make clear that the U.S. needs a comprehensive strategy that includes vaccinations, while also recognizing their limitations and potential for side-effects.

To date, governments around the world have implemented some good and some bad policies. Lockdowns have proven disastrous to the economy and mental health, to the point that one Canadian woman asked to be euthanized rather than locked down again. Masking may help a bit in certain circumstances but does nothing to help people who are already ill. Mandates and lockdowns also impose a high economic cost that leads to other systematic problems with society, including significant increases in suicides and mental health problems.

Together, vaccines, novel therapies like molnupiravir and, more recently, Pfizer’s PAXLOVID, and repurposed existing therapies are absolutely necessary components of a clear-headed, multifaceted, and realistic strategy to fight – and, over the long term, manage – Covid-19.

The long war on the impact of globally communicable diseases can be won with smart policies that recognize that elimination of viruses is unrealistic. We need to cope in a way that is minimally invasive to our lifestyles and work while also providing people maximum protection.

Jared Whitley began his career as a health sciences reporter in his native Utah. He has also served in the U.S. Senate, the Bush White House, and the defense industry. He has an MBA from Hult International Business School in Dubai.