Andrew Schorr:
Hello, and welcome to Patient Power. I'm Andrew Schorr. We're visiting once again with Dr. Krina Patel, who is a myeloma specialist at MD Anderson Cancer Center in Houston, Texas. Dr. Patel, as we meet with you now, it's kind of a tough time for people worried about the coronavirus, the complications of COVID, and particularly, in many people [who] are elderly with myeloma, they worry about it. What are you saying to your patients when we worry about variants, vaccinations, boosters, visiting at the holiday time? What are you saying?
Dr. Patel:
Yeah, it's unfortunately kind of on repeat sometimes, and I think what we've learned in the last two years is that, especially when there's a new variant coming through, that we don't know as much information on.
What Do We Know About the Omicron Variant?
Dr. Patel:
And we can talk about Omicron in general, but really, the best thing to do is be as safe as possible. Most of my patients that have myeloma, I will say, have immune systems that are not normal, especially if you're on therapy, and certain therapies more so than others. But that decreases your immune system even more. So I tell patients the most that you can do is, of course, getting vaccines, getting the booster. We know that myeloma patients, more myeloma patients, make antibodies, have better responses when they get that third dose, really, that booster.
What Precautions Do You Recommend for Those Who Are Immunocompromised?
Dr. Patel:
The other part is social distancing is still really important. I think it's different in different states right now, of how many people are vaccinated, how many people are actually social distancing. So, really, to know what's going on in your town and your city. And then when you have to go outside, just make sure you're doing everything you possibly can to protect yourself.
Having said this, I know a lot of my patients, myself, my peers, we really want to see our family. We want to see our friends because it's been so long. We've all had boosters, we've done what we're supposed to, so why can't we go see everybody now? I would say the smaller the number of people, the better, and folks that you know are vaccinated and don't have symptoms. You want to be as safe as possible. There's some people even recommending getting tested before people come in. If you're going to have a party or a family gathering at your house, maybe asking folks to actually get tested the day of or the day before to make sure they're not asymptomatically carrying it.
And the real reason behind this is, I wish I could say it's much better and we're fine now, but really, we're not. With Omicron, just in the last week, that is now the majority of the variant that we see, and what we know is at least three times more infective than other variants and maybe even more so in certain situations. And even folks who are isolating at home, they're more likely to give it to their family members, even though they're doing everything they're supposed to inside the house. It's just so much more virulent and more likely to spread, that really, we want you to be as careful as possible because our patients are the ones who are the most likely to get bad infections, still.
Now, the good news is most people with this who have normal immune systems and have been vaccinated have been doing okay. They haven't had to go to the hospital, for instance, or, we're not having as many deaths. However, we don't know in our immunocompromised patients how the vaccines are working and what level of vaccination you really have. And we know that with the Omicron variant, the antibodies that we have don't necessarily work against it. So before, I would say, okay, if my patient had any symptoms, we test them. If they're positive, we give them the antibody, and that's been helping. But now, not all antibodies work against the Omicron.
So, in the end, not to scare anybody, but really, just to be as smart as possible, with the numbers being so high across the country right now, the less you interact with folks, the better, or just being really smart about it, having smaller get-togethers where you know everyone is vaccinated and asymptomatic.
Andrew Schorr:
One last question. You mentioned about the monoclonal antibodies not being especially effective against Omicron. What about these pills that are getting emergency authorization with the FDA, antivirals? Might there be some use there for your myeloma patients if you're worried about the virus?
Dr. Patel:
Yeah, I think so. I know preclinical data has been done to see if things are working, but I don't know of any clinical data. I'm always a little bit wary to say, yes, that's going to be the answer. I hope so. I really hope that that will work against all variants and, really, the mechanism of action hopefully will take care of it. But until I know that it does, I'm still going to be very careful.
Same thing with these other antibodies. They are actually working on going after the spike protein of the Omicron variant, so hopefully we'll have that, too, but it's just going to take a couple of months before we get it. Just like we were given this ability to potentially give any of our patients, even if they don't have COVID, the antibody. However, we don't have the doses. We don't have the supply to do that.
A lot of my patients were calling me saying, "Hey, I heard that the FDA said that, or the CDC said that we can do this. You guys can give me this therapy, even though I don't have COVID, just to help protect me," but we don't have it. So I think it's hopeful, for sure, but it's still going to take us a few months before we are able to apply it to everybody. So I still want everyone to be careful.
Andrew Schorr:
That's it. Be careful, I think, is the bottom line. Thank you for outlining what you're telling your patients. All the best to you, Dr. Patel, and with your family in getting together but in a safe way. Thanks for being with us.
Dr. Patel:
Thank you again for having me.
Andrew Schorr:
I'm Andrew Schorr. Happy holidays. And remember, knowledge can be the best medicine of all.
