Infectious Diseases

There are a lot of COVID-19 vaccines to keep track of lately. So far, the ones from Moderna and Pfizer-BioNTech have been authorized for use in the U.S., but there are plenty of others coming down the pipeline that show promise. One of them is the Novavax vaccine, a protein-based vaccine engineered from the genetic sequence of SARS-CoV-2. This approach is completely different compared to how the mRNA vaccines work, which give your cells the code to make the spike protein themselves, explains Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases. Then, your body develops antibodies in response to these cells. “The efficacy is not as high as the mRNA vaccines, but it still affords a reasonable level of protection,” he says. “If we convert a lethal disease into a nuisance and keep people out of the hospital, I think that’s OK.”

There are two policy stories dominating coverage of the pandemic: reopening schools and vaccine distribution. The frustration around school openings may be distracting from the scale of optimism on the vaccine front, which could render some of these tough conversations moot faster than we realize. Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, says the “extraordinary” vaccines are by far the biggest COVID-19 story. Even as new variants are a cause for concern, vaccines appear to protect against the most severe types of illness for now. Russo says there is “too much focus on possible limitations and not enough on their significant merits that will get us out of this mess.” He notes: “We need to keep pushing and inspiring as many people as possible to get vaccinated as soon as possible as their turn arises.”

The Centers for Disease Control and Prevention (CDC) says that two weeks after you receive both doses of the COVID-19 vaccine, you no longer need to quarantine after travel or exposure. But New York State has not updated its quarantine policies to reflect the CDC’s recommendations. The state has left the decision to individual counties. “The benefit of course is that we can get these individuals back to work and back to what they’re doing and being productive in our community and in our society,” says Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases. Right now, fully vaccinated individuals are exempt from quarantine for 90 days. “That’s because our trial data to date shows that protecting is afforded for at least 90 days. I expect that 90 day mark will be a moving target as we move forward. It’s absolutely critical for people not to interpret this as our vaccine is only good for 90 days,” Russo says.

Two cases of the U.K. variant of COVID-19 have been found in Erie County. In a previous interview with WKBW, Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, said the data shows it does not cause more severe symptoms at this point. “Presently, the data does support that it does not cause a more severe disease, which is obviously good news,” said Russo. Erie County’s health commissioner, Gale R. Burstein, MD, who is a clinical professor of pediatrics, notes: “Because it’s a more aggressive strain we can expect to see more of these cases.” Burstein says the vaccine will help prevent transmission of this virus.

The Western New York region and Erie County continue to see steady declines in the percentage of people testing positive for COVID-19 and the number of people being hospitalized with the virus, but the identification of a more infectious U.K. variant of the coronavirus in Erie County presents a new worry. “Because it is a more transmittable strain, it is a more aggressive strain, until we see more people in the community that are immunized, we’re going to expect to see more of these cases,” says Erie County’s health commissioner Gale R. Burstein, MD, who is a clinical professor of pediatrics. The good news is that individuals who are immunized with either the Pfizer or Moderna vaccines are protected against this virus strain. In addition, those who have contracted COVID-19 and recovered also gain natural immunity against the U.K. variant, says Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases. “If we’re going to have a U.K. variant, this is the best variant to have,” Russo notes.

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, was quoted for a story on WKBW on a judge’s ruling that a local COVID-19 patient be allowed to receive an experimental drug as part of her treatment. “Some studies report a benefit — some studies do not,” said Russo. “Ivermectin is believed to have both anti-inflammatory properties and potentially anti-viral against the new coronavirus.” The story also ran in The Desert Review.

A letter written in the New England Journal of Medicine suggests prioritizing the first dose of the Moderna vaccine to the masses before a second dose. However, health experts warn that the letter may not be fully accurate. “That correspondence to the New England Journal was a sub-analysis of the data submitted to the U.S. Food and Drug Administration,” says Kenneth V. Snyder, MD, PhD, assistant professor of neurosurgery. “Whenever you look at data that wasn’t part of the primary outcome of a trial, you have to be very careful about quoting it as perfectly reproducible.” John A. Sellick Jr., DO, professor of medicine in the Division of Infectious Diseases, agrees with Snyder, saying the letters were based on “fuzzy numbers” and not brand new numbers from a well-done study. “We have to be very careful extrapolating from a re-analysis of sub-groups from the original studies or these uncontrolled, just checking and seeing what some patients have shown, which is what happened in the study from Israel,” Sellick says.

In New York, Gov. Andrew M. Cuomo has said indoor family entertainment centers can reopen March 26, and amusement parks — like Six Flags Darien Lake — can open as early as April. Health experts say that with proper public health measures, amusement parks are not high-risk locations for contracting COVID-19. Noting that it is helpful if dining happens outdoors, Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, says: Since theme park attractions are mostly outdoors, “all of those types of activities – particularly if you’re going to package them together with distancing and masks – are really going to be very safe.” Stagnant and dry indoor air is more conducive to virus transmission. John A. Sellick Jr., DO, professor of medicine in the Division of Infectious Diseases, notes: “The wider open the venue, you’re not sharing contaminated air with other people.”

There are more encouraging signs in the fight against COVID-19 in New York. The state’s single day COVID-19 positivity rate is now below 3 percent for the first time since late November. With positivity numbers down, and more vaccines being distributed, despite the death toll, some are becoming optimistic. “I think the bottleneck in supply is going to be significantly alleviated over the next month and will increase the amount of doses available significantly over the next few weeks. Hopefully, the Johnson and Johnson vaccine will be approved sometime in the next week or so,” says Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases.

With COVID-19 vaccinations underway, it is important to avoid the many kinds of traps that scammers may set. Timothy F. Murphy, MD, SUNY Distinguished Professor of medicine in the Division of Infectious Diseases, says any time you are asked for money, credit card information or your social security number, that is a scam. “The supply of vaccine is low and the demand is high, so there will be scams going around,” he says. “Now in New York state everyone over the age of 65 is eligible. That is a huge segment of our population, and many scams that are prevalent target elderly people.” Murphy says you should hang up on any scam calls or delete emails with strange links and report any scams you may receive.

The risk of catching the coronavirus on an airplane, and ways to reduce that risk, have been well documented since SARS-CoV-2 started spreading across the world. But airports come with their own potential dangers that people should consider as they prepare to take a flight. Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, advises people to eat and drink before going to the airport. “The risk is whenever your mask is down,” he says. “You do want to avoid the temptation of sitting there and having the preflight drink or meal. I do not recommend that at all.” For those who must eat something, Russo recommends finding a grab-and-go item — and then going as far as possible from other people to eat it. Once it’s time to board the aircraft, Russo said it is best to avoid any stampede. “Let everybody get on there and wait,” he says. “Even though masks significantly mitigate risk, they’re imperfect.”

After almost a year of dealing with the coronavirus pandemic, there is still the question of when life will get back to some level of normalcy. Experts say this has a lot to do with when we reach herd immunity. “Essentially what it is, whichever way you call it, is that once you get to a certain level of immunity in the population, then the disease will not spread as much,” says John A. Sellick Jr., DO, professor of medicine in the Division of Infectious Diseases. “Getting to community or herd immunity is a combination of both the vaccine and natural immunity,” says Sellick. In the meantime, he urges people to continue following public health measures and do their part to stop the spread.

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, is quoted on a story on new research that looks at how well COVID-19 vaccines perform against new variants of the virus. “If we extrapolate the findings from the Johnson and Johnson vaccine to the vaccines that are widely used in the United States at this time, the Pfizer and the Moderna RNA vaccines, both of those vaccines actually demonstrate greater efficacy against non-variant strains than the Johnson and Johnson vaccine,” Russo said. “So, I would expect, though it’s not quite clear if these vaccines will have decreased efficacy similar to the Johnson and Johnson vaccine, it seems highly likely that they’ll protect against serious disease, hospitalizations, and bad outcomes from infections due to these variants.”

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, is mentioned in stories on actress Gwyneth Paltrow as being among the increasing number of COVID-19 patients experiencing lingering symptoms months after being diagnosed with the coronavirus. Russo was quoted from a previous interview when he said that a novel coronavirus infection causes “inflammation” in multiple organs, including the heart, kidneys, gastrointestinal tract, and sometimes the central nervous system. “It takes time to recover from that.”

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, is quoted in a story on when Western New York can expect to reach herd immunity. “It’s been guesstimated that we need probably 70 to 80 percent of the population to have protection against the coronavirus,” he said.