The current global figures of COVID-19 is still rising. Many countries have enforced lockdowns to safeguard its citizens, however in most cases this has been to the dire detriment of the economy. Most leaders and governments have been holding out and looking to the development of a vaccine to be the answer to this COVID-19 pandemic, however at this point in time and for the foreseeable future a viable and widely available vaccine is not likely to be developed. In juxtaposition to the conventional methods countries such as Singapore, Israel, Iceland, Portugal, The Netherlands, Sweden, Hong Kong, Japan, South Korea, Indonesia, Taiwan and Turkey have adopted the concept of herd immunity. It is there for poignant and of the upmost importance that an alternate stratagem is developed and exercised to best facilitate the re-ignition of the country’s economy as well to best protect its citizens from the virus. Models such as herd immunity or a model based thereon are the most logical solution to attain this goal. At this time in the development of the global COVID-19 pandemic it is too early to conclude as to whether a fully-fledged lockdown is more effective and useful than the establishment of herd immunity. In order to achieve the goal of safeguarding the lives of a countries citizens as well as its economy, a mixed method of lockdown and herd immunity is advised. Individuals who are economically active and less susceptible to the virus should adopt the herd immunity model, whereas those who are elderly with concomitant comorbidities should exercise self-isolation and follow the lockdown model. The application of using both models simultaneously, will both capitalize on the advantages of either and negate the drawbacks thereof. This ultimately decreasing the loss of lives whilst still inducing a degree of herd immunity within the general populous.

Antimicrobial resistance is a worldwide and highly quantified risk to global health and is more prevalent than resistance developed in vaccines as both antimicrobial resistance and vaccine resistance develop in different settings and because of alternate mechanisms. Vaccines act as a preventative measure and allow the immune system to kill any pathogen in the initial phases when the load is relatively low. This circumvents the replication of the pathogen and thus prevents the formation of mutations and furthermore resistance which is attributed to those mutations. Mutations in the target and or binding sites of a said therapeutic regime confer resistance more often in antimicrobials than they do vaccines. The alteration of a vaccines binding site does not confer resistance as a vaccine produces a wide spectrum of antibodies due to multiple epitopes on the said antigen, the remaining antibodies are thus still protective. In antimicrobials however, the drug targets a specific site and is not dynamic and thus if a mutation of the site arises, the drug efficacy is reduced. Although vaccine resistance is less quantified it may also pose a substantial risk to Global health as currently evident with the COVID-19 pandemic. The current global pandemic caused by SARS-CoV-2 has developed a host of mutations which are displaying a degree of resistance and reduced efficacy to the vaccines. This reduced efficacy and resistance of the mutations to current vaccination programmes, poses a risk to global health. It is vital for new vaccines to be synthesized to specifically be active against the variants. It is likely that the synthesis and development of new vaccines to counter new variants as they arise will be an ongoing process. It is evident in future that new vaccines to the mutations in COVID-19 may have to be developed as they are for the seasonal influenzae virus.

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The novel SARS-CoV-2 infection has ripped through international health systems and protocols causing unprecedented mortality, morbidity and global trade deficits amounting to billions. Various monoclonal antibodies have been proposed for use in the treatment of COVID-19 infections. One such drug is LY-CoV555 which in an ongoing phase two trial study conducted by Chen P et al, showed to have an elimination of 99.97% of the viral RNA. The monoclonal antibody 47D11 discovered by Wang et al, binds to SARS-CoV-2. The 47D11 has been reconfigured into a human IgG1 isotope. It has shown that the 47D11 mAb effectively neutralizes the SARS-COV-2 virus. The stance and development however for the treatment of COVID-19 with monoclonal antibodies has shifted from a monotherapy to a so-called monoclonal antibody “cocktail” therapy. REGN-COV2 is such a cocktail developed with the use of two monoclonal antibodies REGN10987 and REGN10933 which have subsequently been named Imdevimab and Casirivimab. REGN-COV2 is currently under study in four phase 2 and 3 trial studies. These studies are multicentric in nature and are being conducted to evaluate the drug’s efficacy, dosing and clinical use as compared to the placebo. The mechanism of action of such monoclonal antibodies is related chiefly to the inhibition of the virus’s ability to perform its invasion and multiplication within the human body. The severity coupled with the sheer novelty of the SARSCoV-2 virus demands the use of newer therapies to both decrease the mortality and morbidity in patients suffering from the infection. The use of a combination of monoclonal antibodies is thereby well established and evident to both decrease the viral infection load, but is also useful in disrupting the virus’s life cycle and thus decreases the replication and viral shedding. It is therefore poignant that a combination of monoclonal antibodies, a “cocktail” therapy is employed so as to attack the virus at its various stages and thus this multifaceted approach may enhance the patient’s prognosis.