On the front lines of the COVID-19 battle: A leader in infectious disease research discloses what he has learned about the Moderna vaccine

December 24, 2020
By Olivia Cameron

BY MARCY SHORTUSE- For Dr. Richard Novak, a “vacation” in the time of COVID-19 is a bit of an oxymoron, yet he is giving it a try this week at one of his favorite places, Little Gasparilla Island. He heads the Division of Infectious Diseases at the University of Illinois-Chicago and has led HIV clinical care and vaccine research efforts for more than 25 years. Novak is now also known as “the man behind UIC’s COVID-19 vaccine Phase III clinical trial,” so it’s no stretch of the imagination to figure out he is taking phone interviews and fielding questions about the virus everywhere he goes. His name is now known worldwide as being synonymous with some of the most groundbreaking studies regarding this mysterious virus that has come upon us in the United States and changed our way of living.
It is lucky for us that he is a kind man with an infinite amount of patience, who took time out of his Florida vacation to answer a few questions for a small local newspaper.
For the past 35 years Novak has immersed himself in teaching, research and patient care regarding the treatment of HIV-positive patients in Chicago, and he has founded his
own UIC Community Clinic Network, of which he is the director. He has been researching and conducting HIV studies with high-risk patients during that time, and before that he traveled to Latin America to study dengue fever and malaria. Novak has been on the “Best Doctors in America” list since 1998, and is a fellow of the Infectious Diseases Society of America.
His work with HIV in Chicago led him to create clinics in some of the areas where cases were the highest, with one of the primary reasons being that so many people in the medical field would not commit to treating such a highly infectious population. He has found that the same thing occurs with COVID-19 patients. There is a definite stigma, not only coming from the medical community but from the general population as well. 
UIC is one of 89 test sites around the country (with approximately 30,000 participants) making great strides in learning about potential COVID-19 vaccinations. Of the more than 300 case studies they have done, about 75 percent are either black or Hispanic, i.e., people who have some of the highest rates of becoming very sick or dying from the virus.
Novak answered a few of the questions that many people in Southwest Florida have regarding COVID-19. He admits that research is still in its infancy regarding this virus, but we still know much more now than we did last year at this time.
Boca Beacon: Is there any school of study regarding a link between genetics or environment and the way a person responds to the virus? In other words, why do so many people around us in Southwest Florida who contract COVID-19 become only mildly ill for a short period of time, while that is not the case for others? Could there be a genetic correlation, or is there evidence that sunlight, salt water and salt air could be preventive?
Novak: There is some evidence that some people have genetic predisposition, but it isn’t thought to be an important factor. Within the population at large most people do well; they have a mild case and it moves on. A small percentage get really sick, and it’s worse the older you get. In people over 60, one in five will get seriously ill.
By and large, though, the vast majority of people do fine. Many people who have died are people in nursing homes, or are elderly. Having said that, there are unpredictable cases where some young people have become very ill.
Florida is getting plenty of cases; it’s not like it’s going away. There is plenty of disease here, and hospitals are getting very stressed. 
There is so much misinformation on the internet, so much that is so wrong.
Boca Beacon: Do you think we will begin to see a “COVID-19” season each year like we have with the flu? 
Novak: It’s too soon to tell if we will have a COVID season like a flu season. One of the main reasons that there is a flu season in the country’s colder months is because people move indoors and cough and breathe on each other. Here in Florida that doesn’t happen as much. We live in a close society: We travel, move around a lot and spread disease pretty readily. It’s too soon to know if it will be a seasonal thing. It has fluctuated like the flu pandemic of 1918. This may have to do with people being very aggressive in their methods of social isolation and wearing masks, then slacking off for a while. People get tired of following the rules. In Chicago, we have been experiencing a surge since Thanksgiving.
Boca Beacon: Tell us how your clinical trials with the Moderna vaccine have been going at your lab since August, when you first received it?
Novak:  We were fully enrolled fairly quickly, with about 300 people applying. Because there’s a surge of cases going on, we have some clear results. We had almost 200 people who were randomly assigned either the vaccination or the placebo. Of that number, only a few people got the vaccination, the rest were given placebo vaccinations. Of the people in the study who got the placebo, many people contracted COVID-19. Some became very ill, one died.
There were three situations where they would stop the study: If the vaccine was clearly unsafe they would stop, or if it was not working they would stop. The third situation is what happened … they told us to stop because they had enough information to prove it was working. When they released the results, we found the vaccination had a 95 percent efficacy rate. The FDA authorized it for emergency use at that point. 
This was a double-blind study, meaning neither they nor we knew who got what vaccination. It was administered and they went about with their daily lives. 
We have an unblended group of independent scientists who look at the cases, and they don’t disclose the results unless they stop the study. With so much COVID-19 going around, we had good results with the numbers rapidly accumulating. 
There are still a few things we don’t know about the vaccination, though. We are going to collect more blood samples, we will “unblind” everyone, and hopefully we will be able to answer whether the vaccination can prevent infections. We will measure from the samples to see if they developed antibodies. There is a difference between a person who is vaccinated not getting ill, and that same person not having the potential to infect other people. That’s another thing we are trying to figure out.
Boca Beacon: Does this virus mutate as much as the flu can?
Novak: It does mutate, but maybe not as much as the flu. That’s the nature of viruses; they border on what we call a “living thing.” They have to use your cells and machinery to replicate; they exist because they can do that. They are driven by natural selection, and the forces of natural selection are your immune system. Viruses that are more effective in evading your immune system are known as dominant viruses. The natural trend of any virus is that it tends to, over time, get more efficient and effective in invading your cells. The problem with this particular virus is that it jumps species. The human population can be blamed for destroying and encroaching on other life forms. All of these coronaviruses came from bats or another species.
Boca Beacon: In your opinion, how effective are COVID tests? 
Novak: There are a variety of tests. The most sensitive and most accurate tests are the nasal swabs. They take a good sample, but the method is very sensitive, and with repeated testing the results can stay positive for a very long time. People infected can remain positive for a couple of months. Other tests, including antigen tests, are only 80 percent sensitive. We use saliva-based tests at the university, and we have also found that some people have the virus but are still asymptomatic and aren’t shedding any appreciable virus, so their tests are negative. 
As far as not believing the results of your test, it’s OK to take the information you get with a grain of salt, but you should get the test to have the information to begin with. 
Boca Beacon: Do you believe that mask wearing is beneficial in prohibiting the spread of the virus, and if so, are masks also beneficial against the flu? 
Novak: Yes, they work. Other countries have done a very effective job in controlling their virus with masks and contact tracing. By utilizing those tools in South Korea and New Zealand, they have almost eradicated the virus. The people of South Korea learned that the hard way with the MERS-CoV virus. 
I think what we are going to see is less viral disease in general if people wear masks – fewer colds, and less flu as well. I think society has changed: I don’t think masks are going to go away. There’s still going to be a substantial amount of people wearing masks. It’s become part of our society