Richard Harris

Government officials are trying to figure out how to make better use of drugs that can keep people with COVID-19 out of the hospital. That's an urgent but daunting challenge in Michigan, where hospitals are struggling to keep up with a surge in new cases.

Researchers are reporting some progress in their search for drugs that tamp down the overwhelming immune reaction that can kill a patient with COVID-19.

These reactions are triggered by coronavirus infections and can veer out of control in some people. It's this reaction, rather than the virus itself, that is the real peril for people seriously ill with COVID-19.

A medical team in New York City says it has performed the first complete surgical transplant of a windpipe.

The trachea is basically a tube that transports air to and from the lungs, so you might think it would be easy to transplant. But not so. In fact, trachea transplants have been one of the last big challenges in this area of medicine.

A 56-year-old woman from the Bronx, New York, named Sonia Sein is the recipient. She ended up in the hospital six years ago after a particularly nasty asthma attack. To help her breathe, she says, doctors inserted a tube down her throat.

Doctors treating COVID-19 patients early in the pandemic often reached for antibiotics. But those drugs were not helpful in most cases, and overuse of antibiotics is a serious concern.

More than half a million Americans have received an experimental treatment for COVID-19 called convalescent plasma. But a year into the pandemic, it's not clear who, if anyone, benefits from it.

That uncertainty highlights the challenges scientists have faced in their attempts to evaluate COVID-19 drugs.

On paper, treatment with convalescent plasma makes good sense. The idea is to take blood plasma from people who have recovered from COVID-19 and infuse it into patients with active infections. The antibodies in the donated plasma, in theory, would help fight the virus.

Public health officials say it's important to vaccinate as many people as quickly as possible to reduce the risk posed by new coronavirus variants. One strategy to stretch existing supplies – albeit with huge logistical challenges — would be to give just one dose of the vaccine to people who have recovered from COVID-19.

About half a dozen small studies, all consistent with one another but as yet unpublished, suggest this strategy could work.

Though attention has understandably been on COVID-19 over the last year, nearly as many people in the hospital have died with a different condition: sepsis. A study now casts doubt on a once-promising treatment for this disease.

In 2017, scientists thought they had found a remarkable advance. A researcher in Norfolk, Va., reported that a treatment involving intravenous vitamin C, thiamine, and steroids sharply reduced the risk of death in his sepsis patients.

Tens of thousands of people who volunteered to be in studies of the Pfizer-BioNTech and Moderna COVID-19 vaccines are still participating in follow-up research. But some key questions won't be easily answered, because many people who had been in the placebo group have now opted to take the vaccine.

Even so, there's valuable information to be had in the planned two-year follow-up studies. And that motivated Karen Mott, a 56-year-old job counselor who stuck with the continuing study.

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What will it take to finally halt the spread of the coronavirus in the U.S.? To answer that question we've created a simulation of a mock disease we're calling SIMVID-19.

Mutations in the new coronavirus could reduce the effectiveness of vaccines against it. But vaccines themselves can also drive viral mutations, depending on exactly how the shots are deployed and how effective they are.

So far, vaccines still appear to work against the new strains – though scientists are warily watching a variant that first appeared in South Africa since it seems to reduce vaccine effectiveness. And evolution isn't standing still, so scientists realize they may need to update vaccines to keep them working reliably.

Scientists estimate that somewhere between 70% and 85% of people need to be immune from the coronavirus before the disease will wane through a process known as herd immunity. Both natural immunity and vaccines can play a role in achieving that goal. But getting there won't be easy.

Drugs to treat COVID-19 are being fast-tracked for development, but the pace can't match the astonishing speed that gave birth to the vaccines.

But one year into the pandemic, there has been strong progress toward effective drug treatments, and the groundwork has been laid for drugs to kill the virus and arrest disease.

As the COVID-19 vaccine rolls out, three big questions loom. First, can someone who has been vaccinated still spread the disease? Second, will the vaccine remain effective as the virus itself evolves? And third, how long will the vaccine's protection last?

Answers to these questions lie in our immune systems. And the answers aren't straightforward because our immune systems are both remarkably adept and remarkably challenging to predict.

Monoclonal antibody drugs are supposed to help people with mild to moderate COVID-19 avoid the hospital, but it can be a challenge to find out where the treatment is offered. NPR has heard from people across the country who have been frustrated by this.

They include Shirley Wagoner, an 80-year-old who still hits the ski slopes and helps run the family plumbing business in Spokane Valley, Wash.

First, her sons fell ill and were diagnosed with COVID-19. Then on the Monday after Christmas she came down with the symptoms of a bad cold, including a sore throat and laryngitis.

Many doses of the monoclonal antibody drugs that treat mild to moderate COVID-19 are sitting unused around the country. There are logistical problems with providing these drugs and skepticism over whether they work. But two major health systems have had good success in deploying these medications, and they're reporting hopeful results.

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