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Dr. John Zurlo on COVID-19, Reflections and Future Projections

Infectious disease specialist Dr. Zurlo reflects back on the pandemic, offers updates on the current status of the virus and looks ahead to the future with hope.

It’s hard to believe it’s been two years since the Philadelphia region locked down due to the COVID-19 pandemic. These past two years have been unprecedented, for sure. Along with the difficult parts of the pandemic—the lockdowns, the deaths, the variants and more—we’ve witnessed the tireless dedication of healthcare professionals and frontline workers, as well as incredible developments in vaccinations and treatments.

While we’d like to say goodbye to COVID, the pandemic is not quite over. But, the good news is, the future holds brighter days. So today, we sit down with Dr. Zurlo to reflect back on the past two years of the pandemic, get an update on the latest COVID news, and look ahead to see what’s next.

Where are we today?

After a stressful fall and winter season filled with new variants like delta and omicron, we’re finally seeing a significant drop in COVID cases across the country. “It seems we’re finishing out the Omicron chapter of the pandemic,” says Dr. John Zurlo, chief of infectious diseases at Jefferson. “Whether this will be the last chapter or not remains to be seen.”

While there may be more variants and sub-variants that appear, it’s unclear if they’ll develop into variants of interest (those that have significant genetic changes) or variants of concern (those with clear biologic advantage for infectivity or severity of disease).

What precautions should we still be taking?

As cases drop, it’s a point of national debate whether we should be dropping COVID-related restrictions and lightening up on our own personal precautions. “It’s most important to look at the stress of COVID on the healthcare system, just as the CDC is doing with its recently updated guidelines,” says Dr. Zurlo. “Even though omicron is highly contagious, the number of people being hospitalized from the variant is comparatively low. With a combination of previous infections and vaccinations, there’s quite a bit of immunity in the population.”

As far as taking precautions, Dr. Zurlo believes it’s safe to start dropping restrictions, as long as the case numbers stay low. “We can’t live like this forever, and it’s time to start the process of reopening—the city of Philadelphia has guidelines in place to determine what the case numbers should look like in order to drop masking policies and more.”

Masking, however, is still necessary in a healthcare setting—providers have an obligation to keep their patients safe. “I don’t think it’ll be long before we stop using masks in other public places,” says Dr. Zurlo.

[Editor’s Note: Since our interview with Dr. Zurlo, the City of Philadelphia declared response level “All Clear.” Read more about these updates here.]

Are vaccines are still important?

We’ve proven over and over again the importance of vaccines. “While we had initial hope at the start of the COVID vaccine era, around December 2020, that vaccines would be highly effective in preventing symptomatic infection and transmission, we’ve discovered that they lose potency over time and with new variants,” says Dr. Zurlo.

“But studies have shown over and over that vaccines have been extremely effective in preventing people from getting very sick with COVID—which means they are still very important in the process of mitigating the effects of the virus and staying healthy.”

The future of COVID vaccines is still to be determined. The U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are taking a cautionary approach to approving vaccines for children under five years old. What remains unclear is whether or not adults at normal risk will need more booster shots, and how often.

Dr. John Zurlo standing in front of Thomas Jefferson University Hospital in Center City Philadelphia.
Dr. John Zurlo sitting in front of the decorated Thomas Jefferson University Hospital bridge in 2020, adorned with an inspirational message. (Photo credit: ©Thomas Jefferson University Photography Services)

How have treatment options changed?

Treatment options for severe COVID infections have made great strides over the past two years. “Monoclonal antibodies are widely available and highly effective in preventing hospitalization in high-risk COVID patients,” says Dr. Zurlo. “The problem is, it’s a challenge for people to get this treatment early enough. It’s not a solution that meets the masses.”

Thankfully, there are two oral medications that have been approved for emergency use by the FDA. These treatments should be taken within five days of the onset of symptoms. “It’s important to act quickly if you think you have COVID-19 and are at high risk for severe disease. Once you develop symptoms, contact your physician to get a COVID test. If it comes back positive, they can prescribe the oral medication for you to take,” says Dr. Zurlo.

What have we learned from the past two years?

The pandemic has been a challenging learning experience for everyone. Healthcare enterprises had to invent things on the fly—policies, procedures, reactions to new developments.

Dr. Zurlo reflects: “I’ve been an infectious disease doctor for many years. When I started my career, we were facing the HIV/AIDS pandemic—we still were uncertain how this very lethal disease was being transmitted. But we got to know the enemy and how it spreads and developed an incredible amount of research and understanding of immunology and antiviral medications.

“COVID is quite different—for one, it’s so much more transmissible than HIV, as a respiratory virus. Infectious disease doctors envisioned this kind of thing happening. We witnessed MRSA, SARS, Ebola … but none of those turned into a worldwide pandemic. I’m hoping we can catalog our experiences with COVID to be better prepared to face a pandemic in the future.”

When will the pandemic end?

This is the question that people have been asking since March 2020: When will it end? We still don’t know, but things are looking hopeful. “Surely if we see the number of cases continue to stay consistently low, we will be looking at the end of the pandemic,” says Dr. Zurlo. The end of the pandemic may not mean the elimination of the COVID virus, but rather its transition to an endemic infection—one that’s still present but relatively predictable, more like influenza.

“I’m optimistic. With the number of individuals who have been infected and vaccinated, we have a much higher degree of immunity to COVID, especially as compared to two years ago when there was zero immunity,” he says. “We’re not going to live like this forever, with COVID hanging over our heads. Everything changes.”

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COVID-19, From the Experts