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Congress has opportunity to greatly improve pandemic strategy

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This article defines a more effective public health strategy for the current COVID pandemic. The core issue is that there is a huge array of reactions to both COVID infections and vaccines based on diverse biology, genetics and medical conditions of individuals. Missing from current policy is recognition and support of personalized medical methods.

First, medical history tells us the wisdom of making the medicine fit the person. This is the cornerstone of what is called personalized or individualized medicine. Good physicians also find the combination of drugs to best address an illness or disease. This contrasts with mass use of off-the-shelf, one-size-fits-all drugs. Proposed here is an approach to tailor or fine-tune medical solutions to individual biologic and genetic characteristics, and personal medical needs and circumstances.

As an example of how trying to get the public to accept a mass medicine is the case of seasonal flu vaccines. A large fraction of the public does not take them. During the 2019-2020 season, 63.8% of children between six months and 17 years got a flu shot. Among adults, just 48.4% of people got flu shots.

Why is this? Because it is common knowledge that their efficacy rate is relatively low. On average, people who get the flu shot are between 40% and 60% less likely to catch the virus than unvaccinated individuals. The truth is that the annual flu vaccine does not fit every individual. Even though there is little medical evidence that taking a flu vaccine poses significant health risks. But people know that the flu infection-fatality rate is relatively low. Many individuals make a sensible risk/benefit analysis, concluding that there are insufficient benefits. Others, especially older people with serious medical conditions and possibly weak immune systems, get annual flu shots. The public health system has allowed a personalized approach to seasonal flu vaccines.

And it turns out, based on government data, that low risk is also the case for the current COVID pandemic. For the vast majority of people getting coronavirus infection either means no symptoms or only mild ones not much different than the flu or a very bad cold, and which pass in relatively few days. Here is the reported truth about low coronavirus death risks for healthy people: "CDC showed that 94 % of the reported deaths had multiple comorbidities, thereby reducing the CDC's numbers attributed strictly to COVID-19 to about 35,000 for all age groups." This stands in contrast to the widely reported total of over 730,000 COVID-related deaths. What this shows is the huge variations in how people respond to COVID infections because of their innate differences.

What COVID-infected people do get is natural immunity to this virus that abundant medical research and clinical studies have shown is better than vaccine immunity. The latter declines in about six months, whereas natural immunity lasts longer and better defends against new variants.

Combination of medicines

Besides making the medicine fit the patient is established clinical wisdom for using a combination of drugs. And often, in this pandemic, some doctors use a combination that includes more than several generic medicines and, especially in hospitals, government-approved drugs. Also widely used are vitamins and supplements. The eminent Dr. Peter McCollough has been the leading proponent of using individualized combinations to treat and prevent COVID-infection disease. All this is an alternative to the strategy of mass vaccination for everyone.

Today, anyone without too much work can find a host of combination protocols to treat and prevent COVID.

The missed opportunity discussed early in the pandemic

Between the early 2020 months of the pandemic and the roll-out of mass vaccination in late 2020 there was interest in applying the personalized-medicine approach to managing the pandemic.'

Consider what the Mayo Center for Individualized Medicine said for the COVID-19 response. The document detailed a number of initiatives Mayo was pursuing to address the pandemic by obtaining medical data that could lead to personalized pandemic solutions. This is what Mayo wanted to do:

When COVID-19 spread across the U.S. in March 2020, the Mayo Clinic Center for Individualized Medicine urgently responded to accelerate research, development, translation and implementation of novel tests, lifesaving treatments and diagnostics. Now, collaborative teams of scientists are continuing to unravel the mysteries of the novel virus, including using advanced genetic-sequencing technologies to investigate how the virus can infiltrate a person's immune system and wreak havoc on organs, tissue and blood vessels, leaving some patients with long-term effects.

A September 2020 article had the intriguing title "How to use precision medicine to personalize COVID-19 treatment according to the patient's genes." Here are excerpts:

In recent years, a gene-centric approach to precision medicine has been promoted as the future of medicine. It underlies the massive effort funded by the U.S. National Institutes of Health to collect over a million DNA samples under the "All of Us" initiative that began in 2015.

But the imagined future did not include COVID-19. In the rush to find a COVID-19 vaccine and effective therapies, precision medicine has been insignificant. Why is this? And what are its potential contributions?

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Joel S. Hirschhorn is the author of Pandemic Blunder: Fauci and Public Health Blocked Early Home COVID Treatment, Delusional Democracy - Fixing the Republic Without Overthrowing the Government and several other books, as well as hundreds of (more...)

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