Thread by @sumanthraman

What worries me about #Covid is the feeling we all have that come January the vaccine will become available and that will mean a return to normalcy. We only need to go back and look at the history of vaccines for influenza to realize what a fallacy this is.

Influenza vaccines have been available for over 70 years. The first vaccine was produced in the 1930's. Since then despite advances in our understanding of both viruses and vaccine development the newer vaccines have not been very successful in controlling Influenza.

It is believed that the efficacy rates of most modern Influenza vaccines is anywhere between 40-60%. Each year over 500,000 people die due to Influenza. Issue is not just about the availability of the vaccine. The virus is continuously mutating and so

last seasons flu vaccine is no longer protective this year and a new shot (of the new vaccine) is needed. So the logistics of vaccination as an ongoing process year after year is a nightmare.Add to this the costs of the vaccine and you get the picture of the scale of the problem.

So this is not about a vaccine becoming available and everyone gets one shot and we get back to normal life. Few points to note1.A vaccine takes 3-4 weeks for its protective effect to kick in and we remain vulnerable until then. 2. One shot may not be enough and two may be needed

3.After all this we may still end up only with 60% protection. 4.The protection may not last more than 6 months to a year. 5.A new vaccine has to be developed and administered each year. Sixth, it may take a while to study long term side effects of a rushed thru vaccine

7. It may be unaffordable for many. All these are serious concerns. So what should we be doing? IMHO we have a better chance of dealing with #Covid if we focused more on immuno modulants and other drugs that can prevent the most dangerous effects of the virus.

Compared to January of this year we now know a lot more about how Covid causes damage though there is plenty more to learn.Attempting to influence the immune response and reduce the severity of the infection thereby preventing ICU admissions and drastically reducing mortality.

should be our focus.Once we reach the stage where the mortality starts to go below the annual flu mortality numbers the panic will subside. Some of that is already happening just with the use of dexamethasone, anti coagulants, remdesivir etc. While infections from second waves

have risen, death rates haven't gone up proportionately. In large measure this is because of better understanding of the disease and early treatment provided. It could also be due to a weaker strain of the virus but as of now there is little evidence of this.

So our efforts should be on reducing the severity of #Covid infections so that patients do not need ICU care or even hospitalization.While prevention thru vaccines may be an ideal goal,making the disease less threatening/less dangerous may be easier to achieve in the shorter term

This may be our immediate ticket out of jail. Experts kindly give your opinion. #covid #covid19 #COVID19vaccine #coronavirus @EricTopol @VincentRK @DrEricDing @ICMRDELHI @doctorsoumya @devisridhar @MoHFW_INDIA