Mar. 20—Dr. Don Greggain isn't planning any ocean cruises within the next year.
But as the vaccination campaign ramps up and new COVID-19 cases continue to wane, the Lewiston physician is hopeful life will feel mostly normal "by the end of the summer."
Greggain, who is on the front lines of the virus battle at St. Joseph Regional Medical Center, was joined by Dr. Gary Craig, a Spokane rheumatologist with years of experience in vaccine development, for a recent Zoom interview with the Tribune about the coronavirus pandemic. The interview was arranged by retired Clarkston doctor Warren Ellison, who has advocated for people in the valley to get the vaccine since he was inoculated in late December.
The doctors talked about the nature of the virus, the full-tilt effort to develop vaccines and the prospects of the pandemic coming to an end.
"Sneaky dang virus"
Greggain, a family practice doctor, saw "hundreds of patients" during the initial months of the pandemic and, like the rest of the medical community, quickly learned the characteristics of the coronavirus.
He called it a "sneaky dang virus" because of its ability to easily spread and the unpredictable way it can affect each patient.
"I've never seen an infectious disease that has so many other ramifications, or can last as long," he said.
During the first three months of the pandemic, Greggain would often see patients he suspected of having COVID-19, but was only able to send them home with orders to quarantine.
"We only had 300 testing kits that had to last us 12 weeks," he recalled.
The official number of infections in the United States is almost 30 million, but both Greggain and Craig speculated the actual number is significantly larger, because of the early scarcity of tests and the fact some infected people were asymptomatic and never knew they had it.
That may be one reason case numbers have declined of late. Not only is the pace of vaccinations picking up, but those who already had COVID-19 now have some level of resistance to it.
New vaccines "brilliant"
The two most commonly used coronavirus vaccines in the U.S. were developed by pharmaceutical companies Pfizer and Moderna.
Craig called them "very nontraditional vaccines," since they rely on messenger RNA technology that has only been developed in the last 15 years.
The process started not long after the coronavirus was isolated, when researchers identified the type of "spike protein" it uses to attach itself to cells and invade them.
So an mRNA vaccine was developed that instructs some of the body's cells to make the same "spike protein" used by the virus. Once the immune system identifies the protein, it develops antibodies that are ready to neutralize the virus if the real thing ever enters the body.
Vaccines traditionally expose the body to low levels of a virus in order to trigger the immune response, but the mRNA vaccines do the same job without any exposure to the coronavirus.
"It's brilliant," Greggain said. "I really believe it will revolutionize where vaccinations are going to move forward from this point on."
And if one of the emerging variants of the virus becomes a wide-scale threat, the mRNA vaccines could be quickly retooled to deal with those. It would just mean another round of shots for the public.
In clinical trials, the mRNA vaccines' efficacy was more than 90 percent, and real-world studies suggest those who come down with COVID-19 after being vaccinated generally have mild cases.
Craig cited recently released data from Israel. That country completely vaccinated 550,000 people, and of those, only 544 came down with COVID-19.
"The vast majority of (the cases) were mild," said Craig, who has treated many valley residents over the years at his Spokane practice, Arthritis Northwest. "Only 15 people were hospitalized, four were severe, and there were no deaths. And that's out of a half-million vaccinated people."
Developed at warp speed
Some have expressed concern about the speed of the vaccines' development, but the doctors pointed out mRNA technology got a kick-start during would-be pandemics that never quite materialized in 2009 and 2011.
After the COVID-19 pandemic was declared, the Trump administration started Operation Warp Speed, which gave pharmaceutical companies money up front to work on treatments. And during development, the drugmakers sent their side-effect data to the FDA on a daily basis, so it could be evaluated "on the fly," Craig said.
"I personally thought that the Warp Speed thing was brilliant," said Craig, who is on a Pfizer advisory board for vaccinations of rheumatology patients. "They said, 'You make the vaccine, we'll pay for the vaccine — we'll give you the money up front. You can produce plants to make the vaccine before the vaccine is FDA approved, and we already bought the vaccine.' "
Both doctors said concerns about the vaccine altering a person's DNA are unfounded. The mRNA vaccine has "one job to do, and that's to build the spike protein, and that's it," Greggain said. Plus, the mRNA is "destroyed" after a few days in the body, Craig said.
Many of the coronavirus vaccines were developed using human cell lines that were derived from aborted fetal tissue 40 years ago, Craig said. The Pfizer and Moderna vaccines used the cell lines for confirmation tests only, while other vaccines, like the Johnson & Johnson version, used the cell lines in development, confirmation and production.
"The Catholic church has already commented on this," Craig said, "and their comment is if you have a choice between a fetal-derived vaccine and an mRNA vaccine, they prefer you to take the mRNA vaccine. But if you have access only to (the other) type of vaccine, the Catholic church says it's OK to do that."
So far, no deaths have been conclusively linked to the new vaccines, and the doctors mentioned just one suspicious death after a vaccination, suffered by a doctor in Florida.
"I think the body of knowledge is getting stronger and stronger about the truth of it, rather than the conspiracy theories," Greggain said. "It's becoming harder and harder and harder for those conspiracy theories to have any grounds, because all of the outcomes that they threatened were going to happen have not been evidenced in those 94 million people we now have vaccinated."
When will it end?
The virus's grip on the country is loosening, and more promising developments are sure to come.
Both doctors advocated for an immediate return to face-to-face learning for young children, and hoped Washington restaurants can more fully open with some safety measures still in place. Greggain also speculated that college football in its traditional format could return in the fall, if vaccine progress continues.
But the coronavirus is far from beaten worldwide, especially in countries where vaccines aren't as prevalent as they are in the U.S.
So when will the pandemic end?
"It depends on how well you can vaccinate the whole world," Craig said.
Baney may be contacted at email@example.com or (208) 848-2262. Follow him on Twitter @MattBaney_Trib.