Common question: If I contract coronavirus tomorrow, what meds would I want? Short answer: Depends where I am. If you sift through all of the breathless #COVID press releases, the only "game-changer" is dexamethasone, a cheap & widely available steroid that saves lives. But... 1/
I would only want it if I'm really sick. Otherwise, it could actually make things worse. Drugs that work in some groups fail in others. Lilly's antibody, bamlanivimab, is weakly effective (maybe?) for patients outside of the hospital but makes things worse for sick patients. 2/
This matters as we think about the vaccine roll out: different groups may respond differently. For example, patients in longterm care facilities (nursing homes, assisted living facilities) may be quite different than the people who actually enrolled in #COVID vaccine trials. 3/
They're presumably older; some may require supplemental oxygen; others may not be able to walk. How do these characteristics affect the immune response? Vaccinating high-risk groups is the right thing to do, but it won't be the end of the story. 4/
We'll need to collect data for months (or years?) to figure out how to optimally protect our most vulnerable (the very old, the very young, the socially marginalized), who are often unable to participate in clinical trials. An important priority for 2021.
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