May 11, 2020

'You don't make the timeline, the virus makes the timeline' *

Lots to think about right now. Tempers in some areas are rising, seemingly based on misinformation. Claims that COVID-19 is not any worse than the flu are partly what is influencing many to call for reopening. But data shows that COVID-19 is worse than the flu. The numbers of COVID-19 deaths are higher than flu deaths, comparing their totals is not so simple and this article helps explain why.

But re-opening too quickly can backfire and cause the second wave to come sooner. Even Dr. Fauci plans to tell Congress that when he testifies this week. I admire the governors and health department officials for sticking to their recommendations and continuing to care about the majority of the citizens. I understand that the protestors are angry and feel desperate, but sometimes their anger seems misguided. Rather than asking for more help to contain the outbreak and help the small businesses survive, their ire is directed at those trying to protect the most people. Such sad and misguided energy. I wish they understood that the timeline is being written by the virus and not the governors. If we can contain it better then we can re-open sooner. I fear that we will start seeing spikes in infections again soon with the loosening of guidelines.

But there actually is some hopeful news in treatment and testing. A combination of treatments showed quicker recovery and better outcomes in a randomized trial. It used a combination of meds: an HIV combination medication lopinavir/ritonavir (Kaletra) plus ribavirin and Beta-interferon vs patients taking only lopinavir/ritonavir. The second two meds have been used in the past to treat Hepatitis C, another RNA virus. This is good news. They did best if they started within 7 days of symptoms. These are meds I would not jump at taking for longterm due to side effects, but think they could be tolerable enough for a couple of weeks, considering the alternatives. Lopinavir/ritonavir can cause diarrhea and ribavirin and interferon can cause fatigue, but usually not in the short term. It seems that the ribavirin and/or interferon are what made the difference.

The other great news is that the antibody test that the company Abbott makes has been validated and has great sensitivity and specificity. Only one false positive out of 125 for specificity of 99.90% and 100% sensitivity, when tested at least 17 days after symptoms started. This is very useful and good to know. It is the antibody test that shows exposure to SARS-CoV-2 virus which causes COVID-19 and the one that my organization is using, so much better than the alternatives. It is helping us see how many people had it and when they had it. With this validation, it is also starting to reassure us that we do get some immunity at least to SARS-CoV-2, we just don’t know how long it lasts.

Like I said when I started writing this blog, things will evolve and change as we learn more. We are learning to treat COVID-19 in more effective ways, which is wonderful. But the more we learn about COVID-19, the more I realize I don’t want to get infected. Why take those risks? I don’t want my friends and loved ones to get infected either. So we must keep learning and sharing new developments, while gently refuting the conspiracies, so that we can stay safe. As Dr. Fauci said: “You don’t make the timeline, the virus does”. Our job is to wash our hands, wear our masks, and use physical distancing. as much as possible. Let’s not stop doing what is working. We can do this. We are doing this.

Wash your hands and cover your nose!

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.nytimes.com/2020/05/11/health/coronavirus-second-wave-infections.html?action=click&module=Spotlight&pgtype=Homepage

https://www.nytimes.com/2020/05/11/us/coronavirus-updates.html?action=click&module=Spotlight&pgtype=Homepage#link-6f63d836

https://www.medpagetoday.com/infectiousdisease/covid19/86176

https://www.nytimes.com/2020/05/11/us/coronavirus-updates.html

https://www.jwatch.org/fw116626/2020/05/10/combo-therapy-with-interferon-shortens-sars-cov-2

https://jcm.asm.org/content/early/2020/05/07/JCM.00941-20

*Anthony Fauci 3/25/2020