Let’s think broadly about the vaccine picture. There are nearly 8 billion people on earth. The drug companies have announced that people will need to return for boosters after 6 months due to the possible waning of the immune response along with necessary revisions for new variants. Given this, does 16–32 billion shots every year for every human on the planet sound practical?
I’m sure the drug companies don’t mind the sound of this, as it would be extremely profitable for them. However, given the rapidly shifting variant picture, vaccines that only produce effective immunity will likely not be enough to stop the pandemic. Health care experts have estimated recently that we would need 80–90% of the population to be vaccinated to have a chance to achieve herd immunity through vaccines. My view is that we will not be able to get this proportion of the population to take these vaccines. Additionally, we will constantly be chasing our tails needing new formulations every 6 months to address whatever brand new variants are forming over time. It sounds like a never ending battle.
I believe the key to ending the pandemic will be killing off as much virus as possible as fast as possible along with stamping out transmission. Below, I outline the strategies I feel are critical to achieving success in defeating Covid.
We urgently need individual use tests for home and/or work that are as simple as pregnancy tests in addition to being cost effective. There are some that have been approved including Quidel’s QuickVue At-Home Test, Cue’s Covid-19 Test for Home, and Ellume’s Covid-19 Home Test. Quidel’s test is an antigen test that causes a color change on a paper test strip. Ease of use seems high for this option but antigen tests are slightly less accurate. Cue’s test is the more accurate molecular based test which produces results within 20 minutes. Ellume’s test is also antigen based and requires a smartphone app to get the results. Unfortunately, the projected cost of Ellume is $30 per test which would make it cost prohibitive for daily testing. Quidel and Cue have not yet announced an estimated sale price. I hope they will be affordable enough for widespread use.
Whether or not people have been vaccinated, when home tests become available, everyone should test themselves regularly (perhaps at least weekly) during the remainder of the pandemic. All workplaces with employees that interact with the public should be required to have workers test prior to the beginning of work every day. Ideally, any workplace that requires workers to be present at a physical location should also implement daily testing.
Anyone who tests positive should be required to stay home and not allowed to return to work until they have had successive negative tests. Individuals who find out by home test that they are positive should also quarantine until testing negative. Workers’ jobs should be protected if they must remain home because of infection and sick leave should be paid for any time off.
Frequent testing and quarantining of anyone with any level of infection is an essential key to ending Covid transmission. Transmission requires an infected person being in proximity to an uninfected person. Asymptomatic and pre-symptomatic infections are typically the most contagious. So, whether or not someone feels sick is irrelevant. Anyone who is Covid positive needs to be isolated.
Research shows that physical distance is tricky. We’ve heard 6 feet as a general distancing standard. However, technically, an MIT study found that no distance is large enough if you are indoors because of ventilation and airflow issues. So, infected people don’t just need to be 6 feet away, they need to not be in the building. If you can keep infected people away from the healthy until the virus is no longer in their system, you can strike a huge blow to viral transmission.
Information is power and everyone needs to know their Covid status so that we can use this information to strike a blow to Covid prevalence and transmission. The fact that most people haven’t known their status during the pandemic has played a large role in cases spiraling out of control during surges.
Until the pandemic is over, there will unfortunately always be times that people in your current environment are infected and shedding virus. Because of this, masks that actually protect the wearer by filtering out viral particles are vital. Upgrading to N95 masks (or similarly protective masks like FFP2/3, KF94, etc.) could make an enormous difference in reducing transmission.
For a very long time, it was nearly impossible to find N95 masks that were available to the general public as retailers were being asked to direct their supplies to healthcare facilities. Fortunately, the Biden administration recently announced that the N95 shortage has been rectified. Likely as a result of this announcement, many major retailers (e.g., Home Depot, Walmart, Amazon, and others) are once again selling these higher level N95 masks to customers.
If you do choose to shop for N95 masks, purchasing a model without ventilation is important as those models allow the wearer to emit virus particles if infected, which is problematic. It is also important to watch an instructional video to learn the proper procedure for taking these masks on and off as well as to perform a basic fit check.
Basic masks have some minimal to moderate protective value but pale in comparison to the protection for the wearer provided by N95 masks. Especially as variants ramp up and we lag in new vaccine formulations, N95s can play a critical role in keeping people more protected from any new version of the virus.
Combining Testing and N95 Masks
In an ideal world, if you could get everyone to dutifully and consistently use these first two techniques (testing and N95 masks) for 30 days, we could essentially bring Covid to its knees and reduce cases to a very minimal, almost non-existent level. However, since so many individuals cry foul about using even a basic mask, I’m not optimistic that we could get full compliance to stamp out the virus. But, in theory, it would work if you could get through to everyone and they would agree to comply.
Gargles & Nasal Rinses
One groundbreaking study examined a variety of mouthwashes/gargles as well as nasal rinses and found that 30 seconds of contact with a nasal rinse solution of sterile saline and 1% Johnson’s Baby Shampoo inactivated between 90 to 99% of SARS-CoV-2. The best performing mouthwash was Listerine antiseptic which inactivated 99.99% of SARS-CoV-2 with a 30 second exposure. But, frankly, all tested mouthwashes did extremely well. Crest Pro Health and CVS antiseptic inactivated between 99.9 to 99.99% at 30 seconds. Orajel antiseptic rinse, CVS peroxide sore mouth, and a 1.5% hydrogen peroxide solution (half 3% peroxide, half water) inactivated between 90 to 99% at 30 seconds.
The first place Covid takes up residence is your airway. And, it takes a bit of time for it to take hold, begin replicating, and cause viral shedding and infection. Using these gargles and nasal rinses is akin to washing your airway and the research certainly shows these are highly effective at killing the virus. Of course, these techniques aren’t a replacement for the standard public health measures like masks. But, if you have spent time in a location with many people, you’ve only worn a basic mask rather than an N95, and others are wearing ill-fitting, lower quality masks or no masks at all, it certainly seems sensible to consider using the measures described in the study to disinfect one’s airway when returning home.
When I found this study I felt very enthusiastic about the overwhelmingly effective results that were detailed. This is the type of information that needs to be reported far and wide. However, do you know how many times I’ve seen this study, which was published in September of 2020, mentioned on television or in print articles? Exactly zero — until now. Covid coverage is too focused on who has or has not taken vaccines and how many vaccines have been administered. The media needs to spend more time sharing preventative techniques that are grounded in research.
Important note: As I am not a medical doctor, I am not directing or advising anyone to use these or any techniques without first consulting your healthcare provider. Nasal rinses in particular must be prepared with great caution. The rinse in the study was sterile saline with a 1% concentration of baby shampoo. My understanding is that one should never use tap water or any unpurified water or liquid as infections can result and in very rare instances people can die from brain eating amoeba, which is not what you want when you are trying to use something as a prevention method. So, again, consult your healthcare provider if you’d like to implement these methods.
Preventative or Therapeutic Medications
There are a variety of currently existing drugs that have been found to tamp down the severity of Covid in infected individuals. Commonplace drugs like antihistamines (Zyrtec and Benadryl specifically) as well as the acid reducing drug, Pepcid (Famotadine), have been shown to lessen Covid severity. It is believed that the effect is related to the histamine blocking properties of all these drugs.
Another existing drug that surprisingly showed an effect is the antidepressant Fluvoxamine. It’s properties as a serotonin reuptake inhibitor are thought to interfere with immune system overreactions that can cause what are known as cytokine storms that are very damaging to those infected.
For people who test positive, it would be ideal to develop “Covid packs” of drugs shown to sometimes be helpful in tamping down infection severity. These should either be available over the counter or at pharmacist discretion when an individual reports a positive Covid home test.
Finally, antiviral medications could become a real game changer. One example is Arbidol, an antiviral manufactured by a Russian drug company. Currently it is not FDA approved in the U.S. but many studies are ongoing and some completed studies demonstrated the drug can actually prevent SARS-Cov2 from entering cells in the body in a large number of cases and can also reduce existing infection severity. These or other antivirals could make an enormous difference in the pandemic battle.
Surprising as it may sound, some research has shown there may be a viral transmission reduction from wearing glasses. One study from China noted that 31.5% of the total population in the area wore glasses but only 5.8% of hospitalized Covid patients were glasses wearers. Another study from India found that those wearing glasses were about three times less likely to contract Covid. Many note that studies like these are not absolutely definitive because the samples examined are relatively small, which is true. However, if it might be helpful in reducing your exposure chances, then why not wear glasses especially when you will be in crowded, higher risk locations? If you are already a glasses wearer, you are all set on this front. If not, you might consider finding a stylish pair of blue light blocking glasses that are very popular at the moment.
Hopefully these go without saying but continuing recommended basic health measures (masks, distancing, sanitizing) is important along with maintaining one’s overall health (attending to any pre-existing conditions, maintaining a healthy weight, etc.)
Research has also shown that low Vitamin D levels at the time of exposure can make folks more susceptible to becoming infected. So general nutrition as well as considering a vitamin supplement could be helpful.
As I said at the beginning of the series, I’m not against vaccines. I just have a number of concerns about the current Covid vaccines that I feel are important to consider. Some virologists make the argument that based on the way our immune system functions along with the fact that these vaccines are so narrowly targeted to a particular spike protein, the current Covid vaccines might actually make the development of more infectious variants more likely. There is a really informative podcast on this topic (DarkHorse Podcast) with host Bret Weinstein featuring Geert Vanden Bossche. Nearly two hours of two Ph.D. scientists talking about the intricacies of our immune system and vaccines.
At present, for those who are in vulnerable groups because of age, health conditions, or occupation, making the decision to take a Covid vaccine is certainly reasonable. For those not in the most vulnerable categories, each individual should make an informed decision about taking a vaccine with the understanding that those who do not should consistently employ other strategies in the toolkit such as the aforementioned testing and N95 masks.
Above all, I think it is critically important for everyone to be fully informed and to know what you are really getting from the current vaccines. We all need to understand that the primary function of these vaccines is to serve as a safety net against serious illness and death. The proportional benefits are reduced when we look at moderate, mild, or asymptomatic infections. The data does show there are some benefits at lower infection levels, albeit not at the 95% or 99% level. Personally, I do not want this virus in my system at all if I can avoid it. So, I am not comfortable with the “oh well, you don’t notice it” attitude so many adopt about possible asymptomatic infection after vaccination. Plus, as I outlined in Part 3, asymptomatic infections can wreak havoc as well.
As I’ve noted a number of times throughout the series, the Covid vaccines do not provide sterilizing immunity as some other vaccines do. In an ideal world, a vaccine that produced sterilizing immunity would be developed in the future. If we had this type of a vaccine, each individual could be an island and once vaccinated and they would be nearly fully protected from any level of infection.
Because the current vaccines only produce effective immunity, it is likely that many vaccinated individuals will get the virus in their system at some level, even if it is asymptomatic. A recent case of a nursing home in Kentucky demonstrated this very clearly. Of the 71 vaccinated residents, 19 contracted Covid and 1 of the 19 actually died. So, in this real world scenario 27% of vaccinated residents became infected after exposure. This is staggeringly at odds with pro-vaccine articles reporting only a 0.008% level of breakthrough infections after vaccination. This article was premature and misleading as most of U.S. vaccinations have occurred within the last month or so which is not enough time to know who might become infected. Additionally, not everyone is being tested so a large proportion of asymptomatic infections are likely to be overlooked.
Covid vaccines are one tool that provides some substantial benefits. However, they are not foolproof or infallible. The vaccines alone do not make people completely safe. But, they can be one component in a multifaceted approach to ending the pandemic.
If everyone would use the techniques outlined, we could get on a fast track to ending the pandemic. But, this will require everyone taking the virus seriously. Despite the impression that many people seem to have developed lately, the pandemic is not over. The current 7-day averages are hovering around the levels of last summer’s second surge (60,000 give or take). Those levels were terrible at the time and then we went on to the catastrophic explosion of November, December, and January. Now, we are just back down to the terrible level which means we have more to do.
Testing and higher quality masking are vital to beating Covid. It will also require that vaccinated individuals participate in all measures and shed any belief that they are completely safe by virtue of the shots alone.
It is essential to put vaccines in context. They could be thought of as akin to wearing a seat belt. A seat belt won’t necessarily keep you from dying in an accident or even keep you from having any injury. It is a layer of protection that will reduce your chances of being injured.
If we can keep from putting only one egg in our basket (i.e., vaccines) and incorporate a multifaceted approach, we could finally begin grinding the Covid pandemic to a halt.