Immunocompromised: The Other Pandemic

Shilo Zylbergold | Best Medicine
Immunocompromised: The Other Pandemic

image by: GetYourBellyOut

Risk-free options do not exist for me, and I do not see them coming anytime soon - Shari Kurita

When it comes to the Covid-19 virus, I’m the one with the target on my chest. Not only am I the helpless prey caught frozen in the cross-hairs of the hunter, but I may as well have a “kick me” sign taped to my back.

Why am I such a prime piece of meat for the pandemic? The answer lies in the fact that I am a card-carrying member of those in the human population who are unfortunate enough to be deemed as immuno-compromised. Not only am I over the age of seventy, but I suffer from a cutaneous lymphoma type of cancer, for which I am presently undergoing chemotherapy, thus further suppressing my natural immune response. As if these defects weren’t enough, I have also been asthmatic since childhood as well as experiencing occasional bouts of atrial fibrillation. You might say that when it comes to being a viable Petrie dish in which the odious virus can incubate, I’ve pretty much hit the jackpot.

Let’s stop for a moment and take a close look at an infection opportunity through the eyes (or tentacles or spike proteins) of a Covid-19 virus. At first glance, I must appear to be an A-1 class host. Sure, I’m weakened by my comorbidities, but it’s not as if I’m about to crumble into dust at a moment’s notice. In fact, the last thing the virus wants is for me to die quickly. No, it needs me alive to use my cellular machinery to help it replicate itself exponentially so it can go on to conquer more super hosts. Think of the creature that was “hatched” in the movie Alien, and you get the picture.

From your point of view, if you are immuno-compromised like me, the virus is like that good-for-nothing brother-in-law couch surfing in your living-room while eating you out of house and home and ruining your life while at the same time claiming that he’s staying only a few more nights until he receives his welfare check and can start getting his fecal matter together.

Let’s face it; you are the poster child for the unwitting victim of the pandemic. You might as well have a front and side view photo of yourself on a “most wanted” notice at the local Covid post office. Your suppressed immune system is like a welcome mat placed out in front of the marauding minions of non-cellular particles.

If you are unfortunate enough to be afflicted by lupus, or cancer, or if you are a transplant recipient or suffer from one of the many autoimmune diseases, then you are the one for whom the Covid-19 virus is especially on the lookout. The immuno-suppressants caused by these diseases, or sometimes the treatments administered to combat these diseases, can allow virtually no antibody response against the virus. It’s a similar feeling to playing one of those ancient video games like Asteroids or Space Invaders, but not having a joystick or controller with which to fight back.

For a very short time, it looked like a game-changer had appeared on the horizon. The FDA was on the brink of granting emergency authorization for the immuno-compromised to receive preventative injections that had proven in clinical trials to reduce risk of severe Covid hospitalization and death.

These new drugs, which were meant to complement but not replace the existing vaccines, came in two forms. The pre-exposure prophylaxis (PrEP) would help to keep you from being infected by the virus and the post-exposure prophylaxis (PEP) was aimed at mitigating the effects of Covid if you had already been infected. The dual monoclonal antibody cocktail form of PEP, named Regen-Cov, manufactured by the Regeneron, could be given to non-hospitalized patients within ten days of the onset of symptoms. It had also proven successful in treating the immuno-compromised who had come in close contact with someone who had tested positive, provided it was infused or injected within four days of exposure. If that wasn’t positive enough, it was being subsidized by the federal government to the tune of $2100 per dose.

Regeneron was even to the point of seeking emergency authorization for its PrEP monoclonal antibody. If it was approved, it would likely be given as a monthly injection (similar to how antibody cocktails have been used to treat HIV patients to help them fight off the virus associated with AIDS).

To everybody’s dismay, however, the new Omicron mutation of the Covid-19 virus changed everything again. Although the monoclonal antibody cocktails were very effective versus the Delta variant of the virus, they were found to have diminished efficacy against the recently mutated variant, Omicron. As a result, Regeneron is switching its research trials to a new generation of antibodies that will be tested against the Omicron virus in the first quarter of 2022. Steps are being taken to efficiently get the new cocktail approved by the FDA as soon as the trials are proven to be successful. Similar to the former monoclonal antibodies, the cocktail targets the spike protein and blocks its ability to invade the human cell. With more than 30 mutations from the spike protein of the original Covid-19 virus, it’s small wonder why it has been so difficult to come up with an antibody that is effective consistently.

Nevertheless, there is no quit in the struggle to halt the pandemic, especially for the immuno-compromised. Pharmaceutical giants, Pfizer and Merck, are now developing oral antiviral pills and have submitted applications to the FDA for emergency treatment. Meanwhile, the British pharma corporation, GlaxoSmithKline, has shown in its preclinical studies that its sotrovimab antibody has proven to be very effective against the Omicron variant, although not yet available because of supply issues.

Nobody asked me, but it seems there is a ray of hope on the horizon for those of us who are immuno-compromised. We have cause to believe that we don’t have to hang our heads and believe we are destined to be eternal “runts of the litter”. If at least one of these new monoclonal antibodies and antivirals really work, we’ll be able to tear that target sign from our chests and join the battle against the enemy virus with chances very much equal to the rest of the human race.

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