Covid-19 – Back to the future

An upcoming RCPI webinar will discuss the latest developments in the pandemic and include insights on the
Israeli vaccination programme

The Institute of Medicine at the RCPI is bringing together leading Irish and international experts on a webinar to share updates and discuss what is now known about Covid-19. This evening webinar on Wednesday 26 January, themed ‘Covid-19: Back to the Future’, is the latest in an ongoing series of RCPI Covid-19 updates over the last two years.

Experts will discuss the latest developments in the pandemic, focussing on the fourth round of vaccinations in Israel, the Omicron variant and the role that antivirals will play going forward. The webinar will also feature some clinical case studies and is free for healthcare professionals.

The event will be chaired by RCPI President Prof Mary Horgan and Dean of the Institute of Medicine Prof Anthony O’Regan. They will be joined by four leading voices in infectious disease medicine – Dr Tal Brosh, Head of the infectious diseases unit in the Samson Assuta Ashdod University Hospital, Ashdod, Israel; Prof Paddy Mallon, Professor of Microbial Diseases in the University College Dublin School of Medicine and Consultant in Infectious Diseases in St Vincent’s University Hospital, Dublin; Dr Catherine Fleming, Consultant in Infectious Disease at Galway University Hospital; and Prof Colm Bergin, Consultant Physician in Infectious Diseases at St James’s Hospital, Dublin.

Ahead of this event, Prof O’Regan, Consultant in Respiratory and Internal Medicine at University Hospital Galway, has stressed the importance of keeping the broader community of healthcare professionals up to date with the latest developments in regard to Covid-19. “Remarkably, it is now almost two years since the first case in Ireland. We’re still learning as we go. Since the beginning, we have tried to share as much information as possible through educational webinars to help create a strong network of shared and evolving expertise.”

Prof Horgan – a Consultant in Infectious Diseases who practices on the frontline in Cork University Hospital, as well as serving on the national public health emergency team – feels that it is crucial to use every tool at our disposal to tackle this and any future waves. “What we’ve learned during this pandemic is that the virus is predictably unpredictable, so it is really important now that we start planning how best to use the tools that we have developed to protect us, both individually and collectively.”

Israel

Dr Brosh is the keynote speaker, bringing insights from Israel, a country that is now administering fourth doses of vaccines and providing data that is being studied around the world on how they are dealing with Covid-19. Since 2010, Dr Brosh has served as Secretary of the advisory committee on epidemic control in the Israeli Ministry of Health, which has become the professional board for Covid-19 response.

He is now co-Chairman of the advisory board on Covid-19 vaccines. According to Dr Brosh, the recent rise of the Omicron variant presented a new challenge in decision-making, in terms of where the Israeli vaccination campaign needed to go next. “The global epidemic of the Omicron variant found the Israeli population with a fairly ‘mature’ booster – more than four or five months – and often among the most vulnerable individuals. Waning immunity was again suspected to contribute, and a decision to administer a second booster was taken lately. In my talk, I will try to present the dilemmas we confronted and the scientific background to our decisions.”

It is well documented that Israel has been at the forefront of early vaccination, reaching high population coverage in a short period of time with their primary campaign and making a clear impact on Covid-19 infections and morbidity. Coinciding with the rise of the Delta variant in June 2021, the surge in infections and resulting research found waning immunity to be the key contributory factor. The booster campaign that ensued had a remarkable impact and once again provided a blueprint for other nations to combat waning immunity in their populations.

Antivirals

Prof Bergin is the National Specialty Director for Infectious Diseases at the RCPI and Dean of Postgraduate Medical Training at the RCPI. His talk will provide an update on managing acute Covid-19 in which he will outline the role of emerging antiviral drug treatments. “The advent of new therapies for the management of Covid-19 will serve as an additional element of the armamentarium to fight the pandemic,” Prof Bergin said. “It is, however, important to assess how these new therapies will contribute to patient outcomes and societal recovery in the setting of a well-vaccinated population and emergence of a new variant of disease, both important factors when reviewing the data available.

“Antiviral stewardship incorporating clinical governance, outcome measurement, patient safety surveillance, and fiscal accountability will be central to the programme being established.”

Infectious disease specialists

Dr Fleming will look at some clinical case that will be relevant to doctors and health care professionals dealing with the disease in patients. Dr Fleming was appointed as the first Consultant in Infectious Disease at Galway University Hospital in 2004 and has since gone on to establish a comprehensive clinical service comprising of general infectious diseases, HIV, sexual health, tuberculosis, hepatitis B and, most recently, Covid-19. She is the Co-Lead of the Infectious Diseases Clinical Care Programme with a focus on Covid diagnosis and management over the past 12 months.

Another infectious disease specialist speaking at this virtual event will be Prof Mallon who will discuss the Omicron
variant, as well as the potential for the emergence of further variants of concern in the future. As a past-President of the Infectious Diseases Society of Ireland (IDSI), he joins a full line-up of IDSI committee members for this event, a group that Prof O’Regan said have been leaders in the management of this virus.

“There’s no doubt that the infectious disease specialists have led out on this, taking on a huge responsibility. Those are the people who have been very much at the frontline – not to say that other people haven’t – but it’s important to recognise that.” Prof Horgan, also an IDSI committee member, stated that one of the key values of the RCPI is the widespread sharing of information. “The important thing is that we have a wide network and that we share our experiences – both scientifically and clinically – within that network. And it’s great that we’re able to leverage on the expertise of other countries to share their knowledge with us. I think that has been really important for the College and for our members and Fellows, that we can access that network.”

Over the last 22 months, the RCPI has held over 30 educational webinars, hybrid and in-person events on Covid-19, connecting thousands of doctors and other healthcare professionals and sharing expertise on how to treat this new disease. Speaking ahead of the event, Prof O’Regan said he anticipates that we will see a shift from acute Covid-19 care in the acute hospital to a predominantly primary care-based approach in the future. “With the impact of vaccination and antivirals, it is hoped that the vast majority of people with Covid-19 infection will be managed in the community,
and hopefully with only mild symptoms.”

For Prof Horgan, the future of the pandemic will be all about “being aware of the uncertainties that come with SARS CoV-2 infection, utilising the tools that we have at our disposal to protect our most vulnerable and scanning the horizon to ensure we are prepared for whatever the virus throws at us next”

This article was produced by the RCPI. The Institute of Medicine: Covid-19: Back to the Future webinar takes place on 26 January at 5pm and is free for all attendees. Visit www.rcpi.ie to book a place.