‘A really big deal’: UNC helps find a new way to prevent COVID-19 outbreaks
Americans have pinned their hopes on COVID-19 vaccines and pointed with frustration at glitches in their rollout, but a vaccine is only one key to our emerging from the pandemic and the suffocating restrictions it has imposed on everyday life.
What’s also needed are the other two legs of a three-legged stool – prevention and treatment. Now what appears to be a major advance in preventing COVID-19 outbreaks has come through a study that involves investigators at the University of North Carolina at Chapel Hill.
UNC doctors and researchers, working with the drugmaker Eli Lilly and the National Institutes of Health, helped to design and conduct the clinical trial involving residents and staff at more than 100 nursing homes. The results indicate that infusions with a monoclonal antibody can not only speed recovery from COVID-19, but can also lower the risk of infection by as much as 80 percent.
Monoclonal antibodies are derived from a clone of white blood cells called B cells, some of which are especially potent against the virus that causes COVID-19. Antibody infusions have been given emergency approval for use in the early treatment of some patients with COVID-19 symptoms – President Trump received the treatment – but this study is the first to show that an infusion with the antibodies may actually prevent infections.
Dr. Myron Cohen, the UNC researcher who proposed and helped to oversee the trial, said, “When I saw the results, it was a really big deal.”
It’s an especially big deal for nursing homes, group homes and other residential settings where one case of COVID-19 can touch off a wildfire of the disease. Long-term care facilities make up only 6 percent of COVID-19 cases but they account for more than one-third of the nation’s 417,000 deaths. Now it appears that monoclonal antibodies could be used to douse the disease before it spreads.
The good news has caveats. The antibody infusion process is time consuming, requires dedicated space and equipment and some uninfected residents and staff may not want to submit to the treatment. Nonetheless, in the event of an outbreak, the infusion will work faster than a vaccine and could be further developed to overcome mutations of the virus.
In discussing the promising results, Cohen, the director UNC’s Institute for Global Health and Infectious Diseases, added a perspective that is often missing amid the hunger for a scientific breakthrough that will quickly free us from the grip of the pandemic. He said the drug, known as bamlanivimab, “Is not a silver bullet. It’s a tool.”
Science has made startling progress in combating COVID-19, but ending this nearly year-long pandemic won’t come with one eureka moment. Cohen noted that there are still questions about how long current vaccines will confer immunity and mutations in the coronavirus could require new vaccines. Meanwhile, even as the pandemic recedes, there will still be flareups of infections.
“This is the beginning not the end,” he said. “We never thought antibodies were the answer to the pandemic.”
That’s why tools as simple as a mask and as complex as monoclonal antibodies will continue to be needed.
“The first thing is behavior change. You don’t need to get this infection. Masks work,” he said. “Vaccinations are important but we are going to need treatments as well.”
Extinguishing this pandemic will require efforts at all levels, from people keeping their distance to scientists uncovering how to block or halt infections. Along with prevention, vaccines and treatments, success will require steady doses of caution and patience.
But if there is no silver bullet that will end the pandemic, the discovery that an infusion for those most vulnerable to COVID-19 could spare many of them the disease is a banner day in the struggle.
This story was originally published January 25, 2021 at 4:00 AM.