COVID-19 public health emergency may end, but need remains for …

February 9, 2023

COVID-19 was the greatest challenge I faced as the U.S. surgeon general.It tested our nations resolve, and yet we made great strides in countering this threat.

Key to this was Operation Warp Speed, which developed and delivered lifesaving vaccines in record time, showing whats possible when government and industry collaborate for the common good.

Vaccines are critical and effective tools in our fight against COVID-19, but they cannot be our only tool. It is clear that when the virus evades vaccines (or when people choose not to take them), therapeutics become our best line of defense to prevent hospitalizations and death. As new elusive variants emerge faster than we can develop vaccines to fight them, new therapies become a more critical lifeline.

Coming off the heels of President Joe Bidens recent announcement to end the COVID-19 national and public health emergencies in May, it is more critical than ever to continue shifting the treatment paradigm and address the persistent unmet need for patients who are still at the greatest risk.

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COVID-19 remains the third leading cause of death in the United States, behind only cancer and heart disease. Even as it becomes more endemic, hundreds of Americans are still dying daily, with most deaths now among the elderly, those with risk factors for severe COVID-19 and immunocompromised individuals.

For high-risk patients, monoclonal antibodies have been critical in saving lives.Unfortunately they are no longer effective against the most common currently circulating variants and have been pulled from the market.

As we continue to see new COVID-19 variants and subvariants emerging in shorter time intervals and with unpredictable levels of severity, we are continually reminded that we are just one mutation away from the possibility of another pandemic.

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And while bivalent vaccines have shown promise, only about 16% of the eligible U.S. population has opted to receive them, leaving more opportunities for this virus to continue evolving beyond our protective means.

Driven by the commitment to save lives, we must continue with urgency and focused efforts on innovative industry and government collaboration particularly through accelerated development and provision of innovative oral COVID-19 antiviral treatments. This is a critical part of pandemic preparedness, now and in the future.

Like other antivirals, Paxlovid is designed to stop a virus from making copies of itself. Paxlovid is authorized for emergency use but not fully approved by the Food and Drug Administration. Pfizer is working on the necessary paperwork.

Unfortunately, treatment development is not keeping pace with this ever-changing virus. Medical professionals across the United States have told me that they are desperate for new therapeutic choices, including easy-to-take oral treatments that can be prescribed soon after the onset of COVID-19 symptoms and prevent severe disease and hospitalization.

While existing antivirals are a much-needed foundation, they are not an option for many patientsand have limitations for already high-risk population groups, including drug-drug interactions and reduced efficacy for people with compromised immune systems.

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Collectively among industry and government sectors, its still our responsibility to ensure these treatments get in the hands of patients as swiftly as possible to lessen the severity of COVID-19 and reduce mortality for those at greater risk.

The U.S. Food and Drug Administration shares these beliefs, and it is essential that the emergency use authorization, which allows the agency to respond more quickly, continue for new treatments when the criteria for issuance is met.

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Despite the now anticipated end in May or sooner of the public health emergency declaration, and the unpredictable nature of COVID-19, our collective commitment to develop and deliver efficacious treatments should continue as a pillar of pandemic preparedness.

We learned valuable lessons from COVID-19 thus far, so we must apply them to the next phase of antiviral development to create oral COVID-19 treatment options that can help us finally put this pandemic in the history books where it belongs.

Dr. Jerome Adams

Dr. Jerome Adams, a former U.S. surgeon general, is a distinguished professor and executive director of health equity initiatives at Purdue University and a member of the USA TODAY Board of Contributors. Follow him on Twitter:@JeromeAdamsMD

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