Evusheld may not have been our perfect get-out-of-jail-free card, like in the game of Monopoly, during the last year. Still, it did provide a similar and perhaps superior degree of safety for the CLL/SLL community compared to that afforded by vaccinations in our friends with a normal immune systems.
Since its emergency authorization on Dec. 6, 2021, for those lucky enough to get a dose or two, it drastically reduced our risk of hospitalizations. In addition, it essentially eliminated the risk of dying from COVID-19 when this potent anti-SARS-CoV-2 antibody cocktail neutralized the dominant strains.
It had a good run of about a year. Still, like Regen-Cov and several others, it ran its course. The emerging dominance of the variant of concerns resistant meant it was no longer effective, and its authorization was pulled. The virus mutates fast. The antibodies are static.
AstraZeneca may have a universal Evusheld V2 in the works, and other companies are developing new antibodies that target more stable parts of the virus to provide more durable protection.
None of this will happen soon enough from our perspective, but we may have some good news or at least some promising trials of new drugs for Pre-Exposure Prophylaxis in the last half of 2023
To quote Shakespeare: “Now is the winter of our discontent.”
But it’s not all sinister. No virus can mutate around a well-fitting N95 mask. And they are readily available and affordable.
All the basic precautions still work.
There is much good COVID-19 news.
- CLL patients have much lower hospitalization rates, and fatal outcomes are thankfully rare.
- We have great antiviral therapies, and resistance does not seem to be a problem.
- We have more experience and a better understanding of the best management of those with severe COVID-19,
- Omicron is a less threatening variant that doesn’t target the lungs the way the original, especially the delta strain, did.
- Although our response to vaccines is less predictable and robust than the general population, most of us gain some degree of protection.
So mask up, avoid crowded and/or poorly ventilated indoor spaces, be socially distant, wash your hands, and don’t touch your face. All these strategies still work. We may not be fully engaged in the world by following these precautions, but we certainly can get out of jail.
And new therapies are coming.
Stay strong. We are all in this together.
Brian Koffman MDCM (retired) MS Ed (he, him, his)
Co-Founder, Executive VP, and Chief Medical Officer, CLL Society, Inc.