Hey, thanks for joining us here on 90S plus.
I'm Chris Bianchi here with Nine News and
medical expert Doctor Pyle Coley for a
bit more about the bivalent as booster
and how it's doing and also a bit more
about COVID and as a whole because,
you know, it's something we haven't
really touched on that much.
And I still think maybe I'm sure
you would probably agree that maybe
it's getting not as much attention
as it probably should be.
I know people are tired of it,
but it's still an issue, isn't it?
It's still very real, Chris.
I mean we're still seeing hundreds of lives.
Every day being lost to COVID-19,
we're seeing a stagnation
in the use of treatments.
And, you know, with the with the White
House suggesting that they might actually
lift the public health emergency,
we might even see less testing,
less availability of treatments,
less access to many of those
resources that we've had.
Yeah. So when you're talking
about the public health emergency,
which the White House may was
looking to do, it looks like over
the course of the next few months,
what does that mean for the average person?
Yeah. So means a couple of things.
First it means is that the politicians are
saying now it is time to stop funding COVID.
And that means less access to
free tests for the uninsured,
even for those of us with insurance.
It also means potentially less access to
free vaccinations to free treatments like
Paxil did some of the monoclonal antibodies,
depending on the variant that you got.
And it could also mean, you know,
even other things that you might
not think about, like food stamps,
for example, during the COVID-19 pandemic,
they had allowed for, you know,
high level of food stamps.
So that benefit might go down many more
people who were getting Medicaid under that.
Public health emergency will
now lose those benefits.
So to me, it's going to be a huge
shift in our day-to-day life,
the way we consume healthcare in general,
but also in how we think about COVID.
And so with that looming on the horizon,
when that happens and those
resources go away,
we have to be even more cognizant
of the fact that we have to protect
ourselves as individuals because
we don't have many of those federal
and governmental resources behind
us if we were to get sick.
And of course, one of those
main ones, the vaccinations,
kind of specifically talk about the
bivalent booster and what do we know.
Right. And how's it working?
So the bivalent booster was
designed to have kind of two
different strains of the virus,
hence the name bivalent
instead of monovalent.
So it had the original Vuja Wuhan
strain which was the original virus
and then they added the Omicron
strain and the idea was to create
a breath and a depth of your immune
response so that you're getting kind
of the the original strain which
was the parent to kind of all the
sub variants and you're getting the
most recent circulating strain,
the Omicron,
so that you're kind of getting
antibody responses against both.
Now that was the theoretical idea.
What we're seeing in some of the
studies that have been published
is that it's still better,
bivalent is better than the previous
monovalent ones with just the Wuhan,
but it's not performing as well
as we had hoped or expected for.
And there could be many different
reasons for that.
And what I mean by that is that
the level to which it boosts
your antibody response,
we're not seeing as robust a
response as we thought we might see.
Now this could actually have worked
against us by putting 2 strains.
To bivalent together,
because basically what the immune
system might be doing is busy making
antibodies to the one that it already knows,
which is that original Wuhan strain,
not making as many antibodies to the
new one which is Omicron variant.
So maybe we've distracted our immune
system too much by giving it two
tasks instead of giving it one.
That's one theory.
The other theory is immune fatigue.
The more that you boost the immune system,
is it possible that your immune system
just kind of getting tired and saying,
I've seen this before,
I'm not going to make that much.
Antibodies to it this time.
And so it's not creating as robust in
antibody response as it could have.
That's another possible theory.
The other thing is there a
dissociation or difference between
circulating antibodies and how
much protection we actually have.
And what I mean by that is you
know our soldiers which are the
antibodies are not out on patrol,
but that doesn't mean they're not
available to go and fight if they need to be.
So they could be living in our lymph
nodes and not necessarily be circulating.
So we may not have high levels
of circulating antibodies.
But we could still have reasonable
protection and then finally,
does the response go away and
how quickly does it go away?
We're seeing with the bivalent boosters
peak response at about four weeks
after get receiving the booster,
but within a few months we do start
to see some of those antibodies wane.
So it only seeming to last a few months,
now it does,
like I said in the New England
Journal of Medicine,
they published an update based
on the current kind of milieu of
the virus that's circulating.
It has pretty good protection.
Of course better than the monovalent, but
again with some of the caveats we discussed,
are we heading to a world or a likelihood
that we're going to be getting COVID
shots a lot a flu shot every year?
I think so. And then the FDA has recently
greenlighted this and I think some of
the things we just talked about what
our highlighted are going to be the
challenges in that annual flu shot.
You know how do we design it such that a,
we're getting a robust antibody response.
Should we be adding a little
something called an adjuvant.
Now sometimes we do this for older
people because their immune systems.
Respond as robustly.
So we actually add like a little
tickler for the immune system
that tickles it even more.
It's called an adjuvant.
It creates a more robust immune response.
Should we be adding that in the
next iteration of the booster?
Should we be just doing model valence
and just looking at these circulating
strain or like we do with the flu,
should we be predicting and looking
ahead at perhaps what the next variant
or sub variant is going to look like
rather than being reactive to the
prior one that just circulated and
then again the timing of the boosters.
It's also interesting because for some
people that have gotten natural infection,
the CDC is now saying about three
months or so to get the booster.
If you've had a natural infection,
do we need to study that better?
You know,
do we need to look at longer periods
or shorter periods and see how
those boost your immune system
and immune response as well?
Yeah. So it's an on the fly thing.
We're still the scientific
community still figuring this out.
With that said, we're about
three years into the pandemic.
Where are we at with it broadly right now?
In terms of cases of the severity
of it and any possible new
variants that could be of concern,
the biggest one that we really seem
to be talking about right now in
terms of sub variants is the XB.
It's a Scrabble variant because it's
got lots of letters in it and you
know just like we like to say that
we're smarter than our parents,
this variant is a next generation
variant of the Omicron variant and it is
smarter than the parent Omicron variant,
smarter at evading our immune system.
In fact it's considered the smartest.
Variant yet in terms of how well it
evades our immune system and that's
that's because it's got all these tricks
up its sleeve to disguise itself to
trigger antibodies to trick our immune
cells which makes it highly infectious.
So this is one of the more infectious
variants we've seen that's why we expect
that it's going to become dominant.
But the good news is it looks just
like its parent and acts like its
parent in terms of the behavior.
So it's still an omicron varied,
which means that the overall illness
thankfully is still mild and you
know we're less likely to end up.
In the hospital,
less likely to get on a ventilator
like we did with prior variants
such as the Delta variant because
this is an Omicron sub variant.
Those bivalent boosters would of course
protect against this because it is derived
from that same lineage of variance.
But because it's spreading so efficiently and
it has that kind of immune escape features,
we could get infected again and
again and we could get infected
even if we've been vaccinated.
So that's why it's really important
for all of us to keep our guard up,
you know,
as we're sort of heading into
the fact that the public health.
Agency is going to go away
because we may have less access
to tests and treatments and such.
So we should still be wearing
our masks in public places.
That's when I'm doing.
We should still have a very low
threshold to get ourselves tested
frequently if we have any symptoms.
And in terms of,
you mentioned the Omicron Survarium,
mostly mostly mild illness.
Is there a concern that we
could get another variant that
is more aggressive or could
produce more severe illness?
For sure, because the
infection begets variance.
So the more infections
we have the more chances.
The virus has to divide and hosts and
more chances it has to to mutate.
Now, thankfully, it's mutated in
our favor and it's become milder.
But certainly one of these mutations
could go awry if we keep having
widespread infection and actually
cause vaccine resistance altogether.
Packs lovid resistance.
We already know that some of the
mutations that these newer variants
have have made them resistant to the
monoclonal antibodies treatment,
so that's actually been revoked
as a treatment for.
Many of the new variants because
it doesn't work anymore.
So as the virus continues to evolve
and we're giving it a platform to
evolve by allowing it to spread,
we really have to be careful because
it doesn't mean everything's over.
The next trick up the sleeve of the
virus could be a more deadly one.
So how should we be thinking about
cobit all overall right now, especially
maybe compared to a year or two ago?
You know, I think we have shifted
from the pandemic to the endemic
mode in the sense that there is a
kind of a stable background rate
we're not seeing a shortage of.
Hospital resources,
we're not seeing you know,
significantly increases in numbers of
people who are getting hospitalized or
getting on ventilators or not having
availability of hospital resources.
So all of that tells me that
we're what I call a steady state,
but that doesn't mean the
steady state is low.
It means the levels are still very,
very high.
And hopefully as time goes on and more of
us either get infected and recover or get
you know the bivalent booster or both,
we will start to have baseline.
Levels of immunity that will
offer cross protection.
So even if we have a cousin of the
Omicron variant or something originate,
we would still have cross protection.
But again,
without necessarily a guarantee of that,
especially with a brand new virus,
not knowing what it's going
to do scientifically,
one of the best things we can do is
continue to do those mitigation measures.
Make sure we're washing our hands,
not touching our face.
Public places.
You've gotta wear those masks.
I still wear it on airplanes.
I wear it in the grocery store
and shopping malls.
It's become part of my daily routine.
And I think that that has been a good
impact of the pandemic on changing
our behaviors because for the longest
time we've sort of you know we.
Buckle down and learn something,
and then when it's over,
we forget how hard it was.
But I want us to not forget,
because I want all those lives
that were lost to not be in vain.
I want all the suffering that
all of us endured as a community
to actually have an impact.
Teach us something about science,
about prevention,
and really help empower us to get
our vaccines and to make sure we're
doing those mitigation measures.
Sounds like good advice overall.
Any final thoughts on this?
No, I would just say that one of the
biggest lessons for me personally
has been the power of. Prevention.
And one of the biggest lessons for me
professionally has been humility in this
pandemic and not taking anything for granted,
whether it's our way of life
or the scientific process or,
you know, the power of the virus.
It's a tiny microscopic thing,
but the way that it changed our lives
has left a lasting impact on me.
And, and I hope for all my fellow Americans,
they take away the same message
that we learn we heal.
This is time for damage control now,
because we've lived through
a traumatic event.
This is going to go down in the
history books and each of us
has actually lived through it.
So hopefully we can take some
important lessons that we can,
you know,
help to sort of mitigate any kind of
future risk and also change our behaviors,
maintain a healthy lifestyle,
take all the nice Silver Linings
from what we've lived through,
absolutely something we've all
lived through and something
we're just still freshly from it,
but still kind of processing some
of those lessons, I suppose.
But Doctor Cooley,
thank you so much for taking your
time and sharing us some of your.
Expertise with us today.
Thanks for having me, Chris.