Frequently Asked Questions about COVID-19
“Shared expectations lead to predictability.”
- Studies on coronavirus-19 immunity
Q: What is the latest about if and for how long immunity might be given after someone recovers from COVID-19??
A: Many studies are underway to examine people who recover from COVID-19 identifying what immunity results that would prevent them from catching the disease a second time. This, of course, has importance in the development of a vaccine that would provide antibodies to prevent future infections. Scientific studies take time to complete. The normal process is for an investigation to examine data, then to write down the methods and results leading to a conclusion. These are then reviewed for validity and reliability by editors before they are published in a peer-review journal. Once published, other investigators can replicate the investigation and confirm similar results are found. This “peer review” leads to discussions where methodologies, sample sizes and characteristics, variable doses and so on are challenged. Only then can a study be confirmed as being accepted as true. Of course, during a pandemic, there is a great pressure to speed up the process as many lives are at risk during the weeks and months required for proven knowledge to be accepted. This results in the public learning about possible “facts” before they are proven, and “accept” them at face value assuming they are the final conclusions. Several studies have been recently reported that have yet to be evaluated under this framework.
Coronavirus-19 is one of many coronavirus strains that exist. The common cold is also caused by four other coronavirus forms. Assuming that different coronavirus share similar general traits, a study was recently conducted by the Amsterdam University. Data had been collected over the past 35 years on the four coronavirus strains that cause the common cold. Each year, 10 men were tested for their coronavirus antibodies. Their ages were between 27 and 66. The result was reported in the press as “frequent reinfections at 12 months post-infection and substantial reduction in antibody levels as soon as 6 months post infections” were observed. “Coronavirus protective immunity is short-lasting.” This study is yet to be published for peer-review. The obvious factors that restrict this as being fact for the coronavirus-19 include that this specific virus was not studied, only men were used in the study, and the sample size – 10 participants – was very small. But the general conclusion can be reached that more studies are needed and there is no guarantee that coronavirus infections always grant immunity.
The Korean CDC is now studying the specifics of coronavirus-19 immunity. This and other investigations have led to a trend being identified – prior infection with a milder form of a coronavirus (like the common cold) may correlate with higher antibody levels after recovery from COVID-19. Other studies are comparing COVID-19 with SARS and MERS (previous epidemics caused by a coronavirus). Early data indicate immunity from coronavirus may last from 1 to 8 years.
A more thorough study has been submitted for publication by the St. George’s University of London. This study attempts to learn how antibody production takes place differently by different patients. Blood samples from 177 patients was examined. 19 percent showed positive for the disease but had no symptoms. 94 percent were hospitalized with COVID-19, and a fourth of these died. Some 73 percent of the patients had an underlying health condition. Among the conclusions are that antibody responses are greater when there is inflammation in the body, and that “non-white” people had a higher chance of having more antibodies and being ill enough to be hospitalized. Other research has found that higher antibody levels are linked to disease severity.
Even if immunity is found to not be long-lasting, advancements in therapeutics and vaccine development over time may be effective in limiting the high infectious and fatality rates. We are used to getting an annual “flu shot” to protect against influenza. If the fatality rate and severe side effects can be mitigated, we could end up living with coronavirus-19 as an endemic disease requiring a second annual “shot.”
- Steroid (dexamethasone) as a therapeutic
Q: What’s this I hear about a steroid being used to cure COVID-19 patients?
A: There is no “cure” for this disease – at least not yet. A recent investigation shows an existing inexpensive steroid drug, Dexamethasone, can improve the survival of some COVID-19 patients, especially for those with severe forms of the disease. A group of 6,400 patients were studied. 2,100 of these were given dexamethasone in low or moderate doses over 10 days. A control group of 4,300 patients received standard care without the steroid being given. The results show a reduction of death by 30% with patients on ventilators, and by 20% for those just taking oxygen. This study has yet to be published for peer review, and the investigators caution against accepting this as an approved method of treatment at this time. They point out that only a fraction of patients with COVI-19 can benefit from this therapy, that use of the steroid for some patients carries added risks, and that prevention (social-distancing, masks, and hand washing) are far more effective by preventing the infection from happening.
- Hydroxychloroquine no longer authorized
Q: Is hydroxychloroquine still being used?
A: On June 15, the Food and Drug Administration revoked the emergency use authorization (EUA) for the use of hydroxychloroquine to treat COVID-19, Based on accumulating evidence, the judgement was made it was no longer reasonable to believe the drug might be effective in treating the disease. The pharmaceutical, which has been touted by president Trump as being effective, can no longer to be used in studies to evaluate this application.
- History repeats itself
Q: Is there anything to be learned from the 1918 pandemic influenza?
A: The author, John M. Barry wrote a comprehensive and detailed history, “The Great Influenza, the Story of the Deadliest Pandemic in History.” His discussion includes the science – as then known – the people, the politics and the impact surrounding our nation’s and the world’s responses. A comparison exists with the planning leading up to the recent Trump rally in Tulsa Oklahoma.
In 1918, the president was Woodrow Wilson. He was unifying the country to support sending soldiers to Europe to participate in World War I. The draft was recruiting thousands of people to serve, and Wilson was forcefully keeping the public’s attention away from the growing pandemic. Military installations were filled with recruits for training and deployment. Shipyards were adding thousands of workers to already crowded cities like Philadelphia. The pandemic was already ravishing the military installations, and public health officials were trying to keep the infection out of the civilian population.
In 2020, president Trump was trying to unify his popularity preparing for the upcoming elections. His focus shifted to renewing the economy and keeping the public’s attention away from the coronavirus-19 pandemic.
Wilson needed to raise money for the war effort. In Philadelphia, it was proposed to hold a large parade to encourage people to buy government Liberty Bonds. In Tulsa, Trump needed to demonstrate he was in control and a rally was proposed to encourage people to come to witness this. In Philadelphia, public health officials at all levels pleaded that the parade should not be held. In Tulsa, public health officials at all levels pleaded the rally should not be held. In Philadelphia, on September 28, 1918, the parade stepped off. It was at least two miles long with several hundred thousand people jammed the entire parade route. In Tulsa, on June 21, 2020, six thousand two hundred people spent from 2 up to more than 4 hours inside the convention center for the rally.
In Philadelphia, with an incubation period of 24 to 72 hours, the pandemic influenza resulted in every hospital bed available being filled after just three days from the parade. Banner in his book states, “In ten days – ten days – the epidemic had exploded from a few hundred civilian cases and one or two deaths a day to hundreds of thousands ill and hundreds of deaths each day” Within a week, over 5,000 deaths had taken place, and this trend continued long into the future.
In Tulsa, after the rally with an incubation period of up to 14 days … (reports will follow!)
To be sure, the characteristics of COVID-9 and the 1918 pandemic are different. Communications technologies are not the same, and scientific knowledge during each of these diseases is not comparable. But even then, lessons can be learned if we can just look back to avoid the mistakes of the past.
- White House Coronavirus Task Force
Q: Is the White House Coronavirus Task Force still there? What’s the latest from Dr. Fauci?
A: The task force, as far as known, still exists. But there has been limited reporting on what is being discussed. Anthony Fauci, MD, who attended many past meetings and press conferences of the task force, is the director of the National Allergy and Infectious Diseases agency. On June 19, the McClatchy news service reporter Michael Wilner reported that Dr. Fauci disapproved of the term “Operation Warp Speed,” the name given to the federal vaccine development effort. The article stated president Trump has pushed the US DHHS to expedite a vaccine “so that the public can glimpse an end to the pandemic ahead of the November presidential vote.” Dr. Fauci said if this happened. He would oppose it because the clinical trials cannot be completed by then. “There can be no chance in the world that I am going to be forced into agreeing to something that I don’t think is safe and scientifically sound. I’ll guarantee you that.”
Stand by.
