As COVID Cases Drop, Local Infectious Disease Experts Pierone, Ramgopal Weigh In | Opinion

As COVID Cases Drop, Local Infectious Disease Experts Pierone, Ramgopal Weigh In | Opinion

Laurence Reisman | 01 Oct, 2021

But I’ve never heard Ramgopal or Gerald Pierone, an infectious disease specialist with offices in Indian River and St. Lucie counties, more optimistic about seeing light at the end of the dark COVID tunnel.

“Things are better,” said Pierone, who, like Ramgopal, since late 2020 has helped COVID-19 patients get better with infused monoclonal antibody treatments. “A few weeks ago, it was really bad.”

Maxed out on monoclonal antibodies

In late August before Florida Gov. Ron DeSantis opened state-run monoclonal antibody clinics, including one in Fort Pierce, Pierone’s clinic was so maxed out it was featured in a national medical blog.

“It was just out of control,” he said of the August barrage of cases, which consisted of 70% unvaccinated patients in worse shape than the 30% of vaccinated patients (often in their 80s with comorbidities). “We couldn’t get people in we wanted to get in.”

The good news: Monoclonal antibody infusions and injections, he said, reduced hospitalization and death by 70% and 80%. The bad news?

“It’s not a fail safe,” he said, noting vaccines are better options.

Volume at the clinic has slowed enough so it could start clinical trials for the next generation of infused or injectable monoclonal antibodies, which could be even more effective.

The game changer, however, is expected to be what Ramgopal dreamed of in February: antiviral pills that attack COVID-19 in a similar way monoclonal antibodies do.

While at least three pills are in the pipeline, Merck announced Wednesday its new oral drug worked against COVID variants and clinical trials would end in November.

COVID-targeted pills game changer?

“If they work, that’s going to be a game changer,” Pierone said. “It’s still very cumbersome and awkward to have to bring people in to give them either injections or infusions. If you can meet them at home with a pill like you would with somebody with bronchitis or whatever, that would be transformational.”

It’s good news even if cases are slowing locally.

“I think we’re through the worst of it,” said Pierone, noting he sees fewer adults, but more children testing positive. “Hopefully this downward trend will continue.

“Is it going to go away completely? No, because there are still people out there, delta is a highly transmissible variant, both for people who are fully vaccinated and for people who are unvaccinated.”

In fact, he said, about 30% of the COVID patients his Whole Family Health Center treats are vaccinated.

“They’re not dying sick (which vaccines are good at preventing), but they’re sick,” he said. “They can transmit it to their friends and family and whoever, so it’s still out there.”

Which is why he and Ramgopal urged, as they did when COVID retreated last winter and spring, for people to continue to socially distance, mask up indoors, avoid large gatherings and get vaccinated.

“Until we get rapid treatment that will kill the virus and stops the spread, that’s the strategy,” Ramgopal said.

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