January is a time for new starts and resolutions. But like other beginnings, the first month of the year for many is a time for reflection on the year past and any lessons it may have to teach us.
It would be an understatement to say that the past year has been anything but remarkable from a health perspective. Some may wish to forget it altogether, but please humor me as we consider it nonetheless.
Clearly, the once-in-a-century pandemic caused by the SARS-CoV-2 virus, also known as COVID-19, has dominated public health and health care since first appearing on the scene a year ago. This new strain of virus from a common family of viruses quickly demonstrated both a capacity for easy person-to-person spread and a relatively high rate of severe illness, especially among the elderly and those with co-existing health conditions ranging from asthma and heart disease to obesity. In addition to learning about risk factors for illness, information about the mechanisms of spread has become clearer.
Just as COVID has raged across our nation, public health experts have advocated the importance of time-proven measures to combat the virus – measures that if fully enacted could bring its spread to a halt. Many of these measures have been the backbone of response to previous epidemics, including Ebola in Africa this past decade. They include physical distancing, avoidance of gatherings, universal mask wearing and hand hygiene. As we face a winter of mounting cases and deaths, these simple measures remain critical tools in the public health and personal response to the pandemic.
Meanwhile, medical science has risen to its biggest challenge of the 21st century. For the first time in history, not one but two vaccines have been developed, studied, authorized for use and implemented in less than a year to combat this dangerous pandemic. But, contrary to concerns about the speed of this effort, both vaccines (Pfizer/BioNTech and Moderna) were subjected to the same rigorous clinical trials as previous vaccines.
The difference was that the technology (messenger RNA) already existed, information about a viral vaccine target (the spike protein) was already known from previous SARS and MERS outbreaks in 2002 and 2012, and the SARS-CoV-2 coronavirus spike protein sequence was made available in January. This combination led to rapid development and early initiation of clinical trials. Such trials have already demonstrated high rates of effectiveness (94% to 95%) in reducing both infection and severe illness from COVID-19.
So now we have both sufficient knowledge about viral spread and susceptibility to severe illness and also the tools, including effective public health measures and effective vaccines, to end the pandemic. All that remains is both the collective will to use the tools at our disposal and a system to efficiently advocate for and implement them.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
