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Response to Dr. Jha’s “A Positive Covid Milestone”

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Authored by Dr. Brian Koffman

The immunocompromised/immunosuppressed (IC/IS) community joins Dr. Ashish Jha in the New York Times article and all of society in celebrating “A Positive Covid Milestone” where “the total number of Americans dying each day is no longer historically abnormal.”  We hope it’s a real change, not just a summer pause in COVID-19 mortality.

At the same time, we remember President Biden’s words in his 2022 State of the Union: “If you’re immunocompromised or have some other vulnerability, we have treatments and free high-quality masks. We’re leaving no one behind or ignoring anyone’s needs as we move forward.”

But is that promise being kept?

The New York Times and Dr. Jha correctly say that the IC/IS community is diverse in its response to vaccines and susceptibility to COVID-19. We urge vaccinations for all but recognize that for a significant minority of Americans, including but not limited to many with blood cancers (including chronic lymphocytic leukemia (CLL), a cancer of the immune system), others on active chemotherapy or immunotherapy, and transplant recipients, will not enjoy the benefit of reliable immunity from vaccines and even prior infections. Research shows that COVID-19 leads to more hospitalizations, ICU admissions, and death in the immunocompromised.

So, while we celebrate the progress, let us not take a foot off the gas in developing protection for those still at risk. We need new monoclonal antibodies for pre-exposure prophylaxis (PrEP) and novel therapeutics. Prior advances in PrEP helped level the playing field for the IC/IS, so we know it can be done, but those antibodies are no longer effective as the virus has evolved. We need the government to support and encourage the development of these new options for our most vulnerable.

The time for the final grand celebration where we all can safely rip off our masks and dance cheek to cheek will be when everyone is protected against this scourge, but not before.

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.