Frequently Asked Questions about COVID-19
“Shared expectations lead to predictability.”
- Washing clothes after shopping
Q: Does it help if you wash clothing after grocery shopping?
A: Coronavirus particles collecting in clothing while shopping presents a very low risk for later infection. The concentration of virus in the air six or more feet distant from an infected person is the standard for social distancing. Any lingering virus particles that fall on one’s clothing is quickly enmeshed in the fibers of the clothing, preventing their easily being carried by hand to the healthy person’s face. If one doesn’t usually wash their clothing after shopping, they should use judgement to evaluate the rare situations that might present a risk. If somebody without a cloth face covering repeatedly coughs only a foot away, you could be at risk. After quickly stepping away, in addition to being concerned about having inhaled aerosoled virus particles, you might want to consider washing your clothes once you get home. It also has to be recognized that even after a routine shopping trip, washing your clothing might be psychologically a meaningful activity. Washing and showering can leave you more comfortable having rid yourself of the image of being “dirtied” by this invisible and threatening enemy.
- Testing swabs
Q. What is the problem we keep hearing about not being able to get the appropriate swabs for testing?
A. The initial diagnostic test authorized by the FDA was based on a previously developed testing process. This involved a swab with a long flexible shaft and a fiber tip to collect a nasopharyngeal specimen – through the nose deeply inserted to the back of the throat. This test procedure was further developed to permit collecting the specimen from just the nasal passages – making it easier for people to collect their own specimens to return to the laboratory for evaluation. A shorter swab is needed but was not approved. The approved long flexible swabs are specialized, and the manufacturer was unable to produce them in quantity rapidly enough for widespread use. Any different swab had to be separately approved by the FDA before testing could continue.
Samples of a spun-polyester on a shorter “Q-Tip similar” swab were submitted to the FDA for testing by U.S. Cotton, a subsidiary of Parkdale, INC of North Carolina. On April 16, the FDA recognized this fully synthetic product for compatibility with coronavirus-19 testing. Production began and the shortage of appropriate swabs now seems to have been alleviated.
- Readiness for “opening up”
Q. What, exactly, is required before a state can decide to open up?
A: On April 16, 2020, the White House released an undated 15-page document listing criteria recommended for opening the economy from current restrictions. The front cover shows the White House logo and that of the CDC. On the cover, it is stated
|
(Note: the following summarizes the requirements before opening up. The full document can be found at: https://dig.abclocal.go.com/wpvi/pdf/trump-state-reopen-Guidelines.pdf )
Before beginning to open up, states need to satisfy the following pre-qualifications:
- 3 statements addressing the reduction of influenza, COVID cases or positive COVID test within a 14-day period,
- Hospitals can treat all patients with routine care,
- Robust testing program including antibody testing at-risk healthcare workers,
- 3 statements addressing the ability to test flu patients, asymptomatic people and trace contacts of resulting positive tested COVID patients,
- 2 statements addressing ability to supply sufficient hospital personnel protective equipment and critical medical equipment when needed, and surged ICU capacity,
- 5 statements calling for plans being created to protect workers in critical industries, those living and working in high-risk facilities such as nursing homes, employees and users of mass transit, for communicating protocols for social distancing, and for monitoring conditions to immediately reinstate any limitations needed to mitigate when needed.
The first observation is that the criteria released by the White House defines the roles and responsibilities of the states; none are given for federal agencies or the White House.
The second observation is that many of the guidelines are not objectively measurable. Subjective evaluation allows different observers to form variable conclusions. A “robust testing program” for antibody might be seen qualifying by a public official while a public health official might not agree because the test system is not FDA authorized. Giving cloth face coverings to bus drivers may be seen by a governor as “protecting employers and users” when such protection is minimal at best.
The third observation: these guidelines are not enforceable. Indeed, the title states they are “Proposed State or Regional” guidelines. While issued by the White House, the president has already violated these guidelines. He recently invoked the Defense Production Act to mandate that meat processing plants remain open – contrary to the White House guideline to “protect workers in critical industries.”
- Remdesiver
Q: How important is the new drug remdesivir in treating COVID-19?
A: Gilead Sciences, Inc. is a research-based biopharmaceutical company headquartered in California. It had previously worked to develop therapeutics against other coronavirus-related viruses. One of these is remdesivir, which interrupts the replication of other corona-like virus inside host cells. This experimental pharmaceutical required human clinical testing on the coronavirus-19 before it can be FDA authorized.
A previous trial in China was stopped because of a lack of qualified candidates. The initial unpublished report indicated that remdesivir did not significantly improve clinical improvement or elimination of the virus. That report was later revised and published as being inconclusive; more testing is needed
A further clinical trial was begun in the United States. The primary test hypothesis was to evaluate the clinical impact between a 5-dose treatment and that using 10 doses. 1,000 hospitalized adult COVID-19 seriously ill but not on a ventilator volunteered to begin the study. Half were given the medication and the other half were given a placebo – a sugar pill. Findings for each group were compared. As the testing proceeded, it was found that the survivors receiving remdesivir were discharged from the hospital an average of 11 days while those who did not receive it averaged 15 days. The entire group receiving the drug had a mortality rate of 8% contrasted with 11.6% for those not given remdesivir. Ethics standards dictated that with these findings, the study could not continue. Those not given the drug had to be given the opportunity to take remdesivir. As the study ended, the data collected indicated no statistical difference between the groups taking the 5-dose and the 10-dose therapies. This is important because manufacturing the medication can result in double the number of future patients that can be treatment.
On May 1, the FDA granted Gilead an Emergency Use Authorization (EUA) allowing remdesivir to be used on non-ventilator seriously ill COVID-19 hospital patients as a therapeutic while continuing further studies. Such studies can include comparing results when paired with other promising drugs. Gilead had already produced 1.5 million vials of the drug and given it to the government for use in the United States. This is enough for 240,000 patients getting 5-dose treatments. The consensus of the scientific community is, “It’s is not a silver bullet.” Benefits are there but they are minimal. This can serve as a foundation for developing additional therapeutics that will be more effective.
- Insect transmission
Q: Can insects like ticks, and mosquitoes infect someone with coronavirus-19?
A: No! Coronavirus-19 infects a person through the respiratory system entering through the mouth, nose or moist tissues of the eyes. Other virus infections enter through the bloodstream. An example is Eastern Equine Encephalitis (EEE). Blood-drawing insects do transmit these other virus infections, but do not infect with respiratory a virus.
