FSU MED Magazine Fall 2020, Vol. 16 Fall 2020 - Page 34

Second Opinion

Second Opinion

ROUNDS

pandemic . Using a CDC model to estimate COVID-19 ’ s impact on hepatitis B outcomes
optimistic . Development efforts have been achieved in record time . There are over 300
with immunizations being disrupted , I found
COVID-19 vaccine candidates , over 30 in clinical
that a 20 % decline would lead to more than
trials and at least nine in phase 3 . Many of
ROBERT D . ALLISON ( M . D ., ’ 06 )
700,000 excess hepatitis B infections and 120,000 additional related deaths in the Western
these studies have shown neutralizing antibody and cell-mediated immune responses . The
November 2020
Pacific Region ’ s 2020 birth cohort .
current but ever-changing general consensus
CDC Medical Officer , Global Immunization Division Faculty Associate , Johns Hopkins Bloomberg School of Public Health
So what do the pandemic ’ s next six months hold for us ? Before the summer , we predicted a spike
is that a vaccine will be available by the end of the year . It ’ s unknown how long it will take to vaccinate a sufficient percentage of the
in fall and winter cases , consistent with low
population and what the duration of immunity

I

n early 2020 I accepted a new
assignment with the CDC to support
the hepatitis B virus elimination
population immunity and the seasonal pattern of other beta-coronaviruses . What ’ s less clear is whether being infected with both influenza and SARS-CoV-2 will increase the severity of
will be . It ’ s encouraging that federal , state and local public health have been urgently ramping up deployment strategies and capacity .
program in the WHO Western Pacific
outcomes . The safest bet is for everyone to get
We haven ’ t faced a public health emergency
Region ., based in Manila . COVID-19 cases
their flu shots as soon as possible .
of this magnitude for over 100 years . We owe
spiked in the U . S . two weeks before my move
The best way to prevent transmission will
a tremendous debt of gratitude to the front-
and all CDC travel was put on indefinite hold .
continue to be use of face coverings , social
line doctors , nurses , first responders and their
I was reassigned to COVID-19 response where
distancing and good hand hygiene – likely until
families for their herculean efforts and sacrifices .
my role under the Chief Medical Officer was to
at least mid-2021 . But consider : face coverings
They will be strained to their limits again as we
produce near real-time , evidence-based reviews
are about 50 % effective at blocking large-
face spikes in the fall and winter . To win this we
and recommendations for the COVID-19
particle aerosols carrying a virus . They protect
need to support each other , strongly advocate
incident command and CDC leadership .
other people from infected symptomatic and
for sufficient resources and ensure decisions are
My assignments included tackling some of
asymptomatic wearers , and they offer some
evidence-based and that public health responses
the most charged questions at that time . For
protection for a person wearing the mask . This
are appropriate and effective .
instance , would SARS-CoV-2 transmission
underscores the importance of social distancing :
decline in the warmer summer months allowing
maintaining a minimum six-foot buffer , but as
Editor ’ s note : The informed opinions expressed here
a safe phased reopening ? Should we expect
far away as possible . We know a lot more now
are solely those of Dr . Allison , who relied on the
a spike in the colder fall and winter months ?
about small-particle airborne transmission – that
best available evidence at the time of FSU MED ’ s
Are new onset loss of smell and / or taste
these particles travel much farther than six feet .
publication . His opinion is consistent with public
a marker ( s ) for SARS-CoV-2 infection ? Is
While the degree of contribution of airborne
statements and testimony from senior scientists and
hydroxychloroquine an effective treatment ?
transmission to infection is still unclear , the best
public-health officials .
And does use of cloth facial coverings by
bet is to maintain the greatest separation possible ,
Dr . Allison was a member of the College of
laypeople slow viral spread ?
particularly in enclosed spaces where ventilation is
Medicine ’ s inaugural class but graduated with the Class
As the impact of COVID-19 on delivery
not optimal .
of 2006 after taking a year off from medical school
of primary and preventive care became
to train at the NIH . His mentor there , Harvey Alter ,
more evident , my role shifted to helping
Finally , when are we going to get a safe
was recently awarded the Nobel Prize in Physiology
WHO address notable declines in childhood
and effective vaccine ? How long will it take
or Medicine in October for his role in discovering the
immunization coverage , and in particular ,
to vaccinate enough people to attain herd
hepatitis C virus . Allison served as a post-doc under
to hepatitis B vaccine delivery . Childhood
immunity ( generally thought to require 60-
Alter ( 2006-08 ) and took over as the chief scientist in
hepatitis B vaccinations in the U . S . and globally
80 % of the population )? And how long will
his NIH lab in 2016 .
have declined by 20 % or more during the
immunity last ? I believe we can be cautiously

FSUMED

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