After a year of studying and treating COVID-19, clinicians and experts generally know what works and what doesn’t, but developing an infrastructure for treatment and getting correct information out is still a challenge.
In reflecting on a year of COVID-19, Dr. Rajesh Gandhi, Treatment and Management Guidelines Expert Panel chair and professor of medicine at Harvard Medical School, said we finally have sufficient data to treat the disease, but that’s still not enough.
That was the message during the briefing this week by the Infectious Diseases Society of America that also included Dr. Adarsh Bhimraj, head of Neurologic Infectious Disease at the Cleveland Clinic in Ohio.
“We have made tremendous progress,” Gandhi said. “Last March and April, we really didn’t know how to treat COVID-19; clinicians, including myself, were using almost like a kitchen-sink approach because we didn’t know how to treat it.”
About a year later, clinicians for the most part know what works and what doesn’t. “We now have sufficient data to support several treatments, and we also know what doesn’t work, which is critically important,” Gandhi said. “If you don’t know what works and what doesn’t, you end up using drugs that are not beneficial, and in fact may harm people and distract from what does work.”
But more study is needed for this pandemic — and for the next one.
“The other takeaway is that we absolutely need to prepare for doing studies before a pandemic hits, rather than during one,” Gandhi said. “Trying to do these studies in the midst of a pandemic was particularly challenging and reminds us we need strong public health and clinical health research infrastructure going into pandemics, not trying to build them during a pandemic.”
The U.S. got caught unprepared for the pandemic, without adequate information or an infrastructure to deal with testing individuals and treating those who may have been infected by the disease. “The sad reality is we don’t have an infrastructure like adequate medication supplied to communities who are most affected. We are trying our best, but I think we fall short,” Bhimraj said. “The second thing is having the right information. We can do a better job of how we package the information and communicate it.”
Bhimraj said there has been an overwhelming number of COVID-19 studies with “varying quality of evidence. We still have misinformation about COVID-19 that is influencing patients, politics and health-care providers.”
Both doctors said the evidence thus far proves that the vaccines work. There have been few cases of people who have been vaccinated who ended up catching COVID-19, and of those most had minor cases. Also, most of those who have been vaccinated and still caught COVID-19 had received the Moderna or Pfizer vaccines and were infected between doses.
“I think the lesson that I’ve learned from these experiences is after they get the first dose they were masking less and not social distancing as much,” Bhimraj said. “They key point is yes, vaccines protect us, but we should still do the other measures between doses and even after doses.”