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ESSAY: It Will Take More Than a Vaccine to Beat COVID-19

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...In the popular imagination, a coronavirus vaccine will bring the pandemic to a decisive end. And yet not all vaccines are as powerful as the one Salk developed. Many vaccines are only partly effective, or work better for some age groups than others; the immunity a vaccine confers can wane with time, and a shot that’s hard to manufacture or distribute could remain unavailable to many of us. Last week, the Centers for Disease Control sent a letter to state governments telling them to prepare for the possible distribution of a coronavirus vaccine this fall; it described the progress of “Vaccine A” and “Vaccine B”—almost certainly the vaccines being developed by Pfizer and Moderna, respectively.

Though these vaccines are promising, there is no guarantee that they will be cure-alls. “Unless you have a perfect vaccine, which very few are, you’ll always have people who end up getting sick,” Fauci said. “With or without a vaccine, we’re going to need other treatments.”

We could get lucky. But we need to be prepared for the possibility that, in the absence of a single-shot cure, it will be the tuberculosis model—incremental, simultaneous progress on multiple fronts—that gets us through the coronavirus pandemic. It’s a good thing, then, that vaccine research programs aren’t the only ones progressing at unprecedented speed. Three kinds of therapies currently in development—antiviral drugs, antibodies, and immunomodulators—may be ready soon. Alone or in combination with a vaccine, they could help us turn the tide.

There are lots of ways to fight back against SARS-CoV-2 and COVID-19, the disease it causes. We can limit the virus’s spread in the population at large; we can also build barriers against infection for at-risk people, such as caregivers or essential workers, in particular. We can devise therapies that prevent the newly infected from getting worse, and we can create interventions that target the sickest and give them a fighting chance. By surrounding the virus in this way, we can make it less contagious and lethal, changing the character of the pandemic.  ...

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