Orofino,Idaho-Window on the Clearwater
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Delta, Omicron, Molnupiravir, Paxlovid and MAB ? Say what?

by Dr. Kelly McGrath, Clearwater Valley Health

Just when you were getting used to all the "Covid Lingo,"we have some new names in the game. Some of the new terms represent good news, and some are definitely bad news. None of these are unanticipated or surprises, however.

The two big bad players in this continuing Covid journey are the Delta variant and the new Omicron variant of the virus. Compared to some viruses, the Covid virus does not mutate as rapidly to form new strains; however, the current problem is that Covid is now circulating widely, particularly in countries and communities with low vaccine rates. Even with its low mutation rate, Covid continues to have enormous ongoing opportunities to mutate into more powerful forms. This is what is happening currently.

The Delta variant is still the dominant virus in America right now and this is definitely true in Idaho with almost all of the SARS-Cov-2 (the virus causing Covid 19) infections being with the Delta variant. The Delta variant is the virus that has caused the surge we have been experiencing in North Idaho since early August; although the hospitalization rates are a bit lower than in October, Delta continues to cause disease, hospitalizations and death in our own community. It also has overwhelmed our region's hospitals, making it hard to have resources available to care for other diagnoses. Delta is more infectious than prior variants and, as mentioned, has cut a tragic swath through our community. The reason for this is primarily because of our low local vaccination rate. The Covid vaccines available in the US have been shown to be very effective in lowering the rates of severe disease that results in hospitalization or death. That is exactly what we have seen locally, as virtually all of those requiring hospitalization have not been vaccinated. This breaks the hearts of those of us in healthcare since this is an unnecessary tragedy.

Although the current focus remains on the Delta variant, you likely have heard of the new variant of concern call "Omicron." This strain of the Covid virus is already found in many states in the US and, given its staggering efficiency at spreading, will likely arrive in North Idaho soon, if it has not done so already. Because this virus has so many mutations, there is abundant concern that prior infection may not protect against it, and that the vaccines may be less effective. We will know more over the next few weeks as we get new information on the experience in places where it is present.

The clear strategy though to protect against Omicron is the same as it has been with Delta. Some remain steadfastly entrenched in their refusal to protect themselves with the vaccines and likely will never get vaccinated. However, if you have not been vaccinated and have just been waiting for the "right time" or are "on the fence," this is a key time to get vaccinated. If you have been infected previously but are not yet vaccinated, getting the vaccine now likely will help your body fight off the newer strains much more than just relying on your possible protection from the prior infection. What's worse than getting infected with Covid once? Getting it twice! For those who have been vaccinated, make sure to get your booster dose to prepare your body best to meet the challenge of Delta and Omicron.

So, what was that good news? It is that, in addition to the vaccines, we have some new weapons in our holster to fight Covid. What we have right now, in addition to the vaccines, is the Regen-cov monoclonal antibody infusion (also called "MAB" for short). This is an IV treatment that can be provided to outpatients infected with Covid who are at risk for worse disease. Even being overweight or having diabetes or elevated blood pressure puts one at risk for a bad outcome. The infusion should be given in the first 10 days of illness and prior to the point where oxygen or hospitalization is needed. This is available at Clearwater Valley Health and St. Mary's Health. It reduces the risk of hospitalization by about 70%, which is great.

The new treatment that should soon be available is Molnupiravir. Besides being a mouthful to pronounce, it is an oral medication (a pill) that can be given to those at high risk early in the course of infection to decrease the risk of severe disease. It works by tricking the Covid virus to manufacture faulty parts which gums up its machinery needed to spread in the body. Although not yet available locally, it likely will be soon.

The other new oral medication on the horizon is Paxlovid. This is in the process of FDA approval and probably will be available this winter. It shows even more promise to help reduce the virus' ability to cause severe disease. It does so by interfering with the process that creates the protein portion of the virus needed to spread.

While these new weapons are welcome and could not come at a better time with the looming new threats of Delta and Omicron, the fundamentals of the war on Covid remain the same: stay home if sick, be careful around crowds, if vaccinated, get your booster and if not vaccinated, get vaccinated. Until we can do these things effectively, we will be destined to have Covid continue to impact and threaten us. The choice is ours.

Photo: Dr. Kelly McGrath

Window on the Clearwater
P.O. Box 2444
Orofino, ID 83544
Phone: (208) 476-0733
Fax: (208) 476-4140