Dr. Lee Wilbur has been on the front lines of the COVID-19 pandemic. He is an emergency room physician at CHI St. Vincent Infirmary in Little Rock, working with COVID-19 patients, and also contracted the virus himself this summer. He is the principal investigator for the AstraZeneca phase-3 COVID-19 vaccine trial at the Applied Research Center in Little Rock. He and his wife Lori and their two children attend Christ the King Church in Little Rock and he is the board president of the Arkansas Pregnancy Resource Center. Dr. Wilbur talked about his experience with the virus, information about a vaccine and why Catholics should stay hopeful Sept. 30 in an interview with Arkansas Catholic.
You tested positive July 2 for COVID-19 and experienced chills, muscle aches, fatigue, cough and then a loss of taste on day six, which lasted three weeks. You are 46 years old and healthy. How did you treat yourself?
I did zinc and vitamin D. We, at that time, had learned that vitamin D deficiency COVID patients can be worse. And rather than check my vitamin D level, I went ahead and started taking over the counter vitamin D. Zinc has been known to decrease the replication of some cold viruses and so I wanted to get on board. We just were starting to learn that in the critically ill a steroid named dexamethasone, the brand name Decadron, was showing some real benefits in the sick. And so I started taking that very early and then I went ahead and took azithromycin. The data on that was not yet conclusive; azithromycin is an antibiotic.
What treatments have worked best for the COVID patients you’ve seen in the ER?
The steroid I mentioned dexamethasone has been shown to be beneficial for sick COVID patients. We now know convalescent plasma is showing very beneficial effects both in the scientific literature and anecdotally. So for the ultra sick if we can get plasma, which is carrying antibodies from former COVID patients, has been shown effective. The antiviral remdesivir appears to be effective in the sick COVID patient as well. And those are the primary therapies that have shown the most promise, as of today's date. These therapies that have been tried and the data's conflicting are azithromycin and hydroxychloroquine. Most of the data that is now emerging, is saying that there's no benefits to hydroxychloroquine and no benefit to azithromycin … The vast majority of COVID patients without comorbidities that are in a high-risk category are going to recover without any of those therapies.
Who is most at risk?
My anecdotal experience is very consistent with what you hear in the media, which is what you learn from the Centers for Disease Control. We know that the elderly, above age 65, are at greater risk than the non-elderly. Both non-elderly and elderly, with cardiac or pulmonary comorbidities, which would include coronary artery disease, chronic obstructive pulmonary disease, or COPD ... What we’re recently learning is the risk of obesity; we're seeing that in people younger than 65 with really no other medical problems, except for significant obesity, they are suffering at a greater rate and have more complications with COVID.
The AstraZeneca vaccine trial will enroll 30,000 participants at multiple sites across the U.S. The Little Rock site hopes to enroll 3,000 participants from central Arkansas within the next three to five months. It’s one of only three trials in the U.S. -- the others being Pfizer and Moderna -- to be in phase three, testing on humans. As the principal investigator in Little Rock, tell us about the vaccine trial.
This vaccine was initially studied in Oxford, England, using a vaccine vector that they've used for many, many vaccines in the past. They just now designed it to target COVID-19. Thousands of humans have already received this vaccine in Europe. And we were allowed to follow that data before it came to America ... Little Rock was chosen one because of our research infrastructure from our team at the Applied Research Center and because Arkansas, when we were selected, was considered a hotspot.
How does this vaccine work?
What it is is an adenovirus. Adenoviruses are very common cold viruses, but they have genetically manipulated that virus not to replicate. So when it is given to a patient, that adenovirus cannot replicate itself. But inserted into that adenovirus is the RNA, which is the genetic material, of COVID-19. So when that vaccine is given, which is an actual attenuated adenovirus, it will insert its genetic material into our human cells. And then our body will then express the protein, the core protein, which is called the S protein on the COVID-19. So that our body then can recognize that and start to make antibodies and ramp up our immune system to be ready in the event that that patient is later infected with Coronavirus, or COVID-19. So, in short, it’s a way to teach our body how to find COVID-19 in the event that you're infected.
How hopeful are you about a successful vaccine?
I was very excited about this coming to America, because it appears that it's going to offer a real chance at combating this pandemic and leading to the great immune response for those that received the vaccine. And looking at the safety profile, it appears that the adverse events, which is a term used in phase-three studies, appears to be very, very minimal. And meaning, the adverse events that were reported, it's an injectable and so patients can report, “Well, it hurts where you inject.”
After many vaccines, you can for a day to two feel somewhat of an almost viral-like illness. Now, please know that you cannot get the adenovirus or COVID-19 from this vaccine. But you can feel after an immunization a little bit of weakness and fatigue, and that then goes away very quickly. So, when I saw that safety profile, I was like, you know, this is something that if this proves to be as effective in America, I would take this personally and likely recommend this to my family.
What would be your predicted timeline that a vaccine would be available?
With Operation Warp Speed, it's unlike anything we have seen when it comes to the approval of certain therapeutics. Typically, therapeutics take years to clear FDA regulation. That appears to be streamlined under Operation Warp Speed that once the FDA sees the safety and efficacy to be reliable, based on their standards, there will be an application for approval to the FDA to start to manufacture and disseminate this vaccine. It's easy to say that a vaccine will be in the market for distribution clearly within the next year. But I fully anticipate it’s much, much sooner than that. Meaning likely in a matter of months, there will likely be a vaccine that will be available.
Because parts of the AstraZeneca vaccine (as well as others in trials) use cell lines commonly believed to be derived from aborted fetal tissue from the 1970s, is it a moral conflict for you as a pro-life Catholic? (See sidebar)
Due to the extent of the pandemic leading to millions of infections, the lack of an alternative vaccine without the use of cell lines derived from fetal tissue and the public health need to have the most effective vaccine available to save lives, I can knowingly participate in good faith. In the event multiple vaccines become available, as a Catholic, I would choose an option not derived from fetal cell lines.
The longer the pandemic stretches on, the less some people are taking it seriously -- what would you emphasize to them?
I want to emphasize for those who are not taking it seriously, please refrain from doing so. Please take this very seriously. Each and every day we are learning more about this virus. This is unlike most things that we've ever experienced in health care, at least for the modern day physician. It is rare for us to have to learn about a condition that's affecting so many people as it's occurring. We're trained to have knowledge about a particular disease process, and we're ready for when the patient comes in with that. In this case, it's been very unusual because we've had to learn day in and day out about the behavior of this virus and what works, as the patient's learning themselves. And so that has been a tremendous challenge. I would ask the patients to truly be patient. We are learning with them.
Why should Catholics have hope?
When you study Church history and world history, sufferings like this have occurred before. The Church is bigger than coronavirus. God is bigger than coronavirus. Our faith is bigger than coronavirus. And so I would really encourage folks to really reflect and discern upon the kind of the depth and the richness of their faith to provide a real perspective on their faith and how that plays a role in Coronavirus. While we are all experiencing some element of suffering, there's some real silver linings in this, and I think allows us to rely more on our faith. So many of the things that we're used to have been taken away from us because of this pandemic. But in a paradoxical way, it I think has cleared the lens that faith is really the vehicle for us to get to eternal life. And so for us to get bogged down with the stresses of the pandemic really kind of goes against what we're taught as Catholics. So this allows us to be a little bit more aspirational to realize what our faith taught us in the first place.
You have had patients die from COVID-19. How do you personally handle that?
My faith plays a huge role in the death and dying process. Being someone who respects and protects and advocates for the sanctity of life, from conception to natural death, there's a real beauty in death. And while it's associated with sadness, in many instances, if I can do my part, to see the dignity and the death process and be with a family as an advocate for them, it really is so helpful for them. It's helpful for the patient, and it's really helpful for me as a provider. So I have really surrendered when it comes to my practice to God's will.
How are you bringing your Catholic faith to your work in combating the COVID-19 pandemic?
The Catholic faith has taught me that in order to truly heal, I do much, much more than just make a diagnosis and prescribe a treatment plan. It's so much greater than that. It's much more based on a relationship I have with the patient and that relationship starts with the dignity I see within them. If I see them exactly the way as I am, created by God, have the exact same dignity, irrespective of any kind of external or internal differences, that I treat them like a brother and a sister.
From a Catholic social justice viewpoint, what kind of flaws in health care have been glaringly obvious during this pandemic?
What we've seen with this pandemic, it has exposed what we have already known to be true that there are certain portions of the population that are at a greater disadvantage than others. And it appears that one of the greatest contributors is poverty. And with poverty is associated lack of access, or decreased access to health care, and less rates of insurance, which is, again, an access issue to healthcare. And with all those contributors, you start to see greater health disparities, you have higher degrees of chronic disease. And in addition to acute disease, because with lack of access, it's more difficult to get things treated early and so when folks are treated, it's later in the course of disease. Then the other social determinant issues also worsen these particular health outcomes.
To see if you qualify to participate in the vaccine trial, call the Applied Research Center at (501) 954-7822.
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