Written by: William Beierwaltes
- Retired Senior Research Scientist, Henry Ford Health System
- Professor of Physiology (Emeritus), Wayne State University School of Medicine, Detroit, Michigan
Question? Why are testing priorities for people that are already ill, and others are not being tested?
Answer: The first priority for testing is health care workers and first responders. In Minnesota, as in many other parts of the country, the availability of testing is limited. However, if someone presents with COVID-19 like symptoms testing occurs to establish that 1) it is the disease so that 2) a treatment protocol can be established, and 3) the possible previous contacts that may now also be infected can be notified and isolated.
Currently, you won't be tested if your symptoms are not severe enough to be admitted to the hospital. Call your physician if you experience difficulty breathing persistent cough or pressure in the chest, confusion or difficulty arousing, or bluish lips or face.
Question? When will all of this end?
Answer: There is no set time frame, as the response in each state is different, and some states have areas of high population density (New York, Seattle, Los Angeles) where the virus can spread more easily.
We are lucky that in Minnesota, our Governor has worked from the beginning with the Public Health and Medical Community to set guidelines and policies based on the best available information and scientific modeling.
The goal is to "flatten the curve" of infections with social distancing, in that if you are not near someone who is infected, you won't contract the disease. So, what is "the curve"? It is the rate of infection. Without social distancing, an infected person will typically infect (at least) 3 others, who will then each infect 3 others, and these 9 will infect 3 others, and these 27 will… (you get the picture). Thus, the rate of folks infected begins to climb exponentially, as we have seen in Italy, Spain and now New York. The biggest problem is that this rapid increase in infected folks quickly exceeds the ability of existing health care to deal with it, which only makes things worse.
Social distancing (and good cleaning habits) reduce the possibility of being infected, and therefore the rate of infection. Thus "the curve" does not increase so quickly, and may even level off (flatten) or decrease. That's the goal. If we do this efficiently as a community, we could be back to some level of normalcy perhaps by June. We'll see.
Question? So, is there a cure possible?
Answer: The is no cure. The only way to prevent coronavirus is with a vaccine. No medications kill viruses, but a vaccine enlists your body's immune system by identifying physical characteristics on the virus so that antibodies can attack it. The good news is that major advances in science over the past 20 years have enhanced our ability to understand all elements of the virus making it easier to develop an effective vaccine. There are at least 2 (and likely more) vaccines already developed and going into clinical
trials to determine if they work (and that there are no dangerous side effects). It is possible that a vaccine could be available by the end of the year.
Question? I keep hearing about some existing medicines like the anti-malarial drugs that may help patients with their recovery. Why aren’t we using these?
Answer: The efficacy of these drugs is based largely upon "anecdotal evidence." That means someone thinks they should work, they have used it in a few patients and the results confirmed their pre-set bias, or they have been used in other viral infections with some success. The good news is that these drugs are already approved for human use, so the potential side effects seem to be minimal. However, we don't know if they will work, or even if they might somehow make things worse. For example, a couple in Arizona took the active ingredients of the anti-malarial (from a fish tank cleaning compound) and it killed the husband in 30 minutes and put the wife in the ICU. These studies need to be done carefully. There are currently two major clinical trials taking place to answer these questions. One is in New York City on their existing population, and the other is at the University of Minnesota. Results from these could be available in as soon as 2-3 months.
There are other studies taking place using the antibody-rich plasma from COVID-19 survivors on patients, and using drugs associated with the enzyme in the lung that appears to be the "receptor" of the virus that allows it to attach and start infecting cells.
Question? Why are we not testing everyone like they have done so effectively in Korea, Singapore, and Iceland?
Answer: We currently do not have the capability to do so, and results have been slow to report even in those tested. Testing everyone is the ideal scenario, as you can figure out where your "hot spots" for infection are, and who really needs to be quarantined. The studies in Iceland found a certain percentage of folks were positive for the virus but had no symptoms. Without testing, these people could unwittingly spread the virus to many others (unless they were practicing social distancing).
The good news is that new testing has already been developed and will debut this week. Two private companies have developed small mobile testing units that can provide a diagnosis in 5-15 minutes rather than days. They can be taken into the field rather than at some central laboratory location and informed decisions about the patient made immediately. In Minnesota, the Mayo Clinic has also developed its own test for COVID-19. Let's hope that these tests get to our population in Minnesota quickly so that our Public Health organizations can really understand what is going on in our state's population and guide the Governor in his strategies.
Question? Can you get coronavirus from drinking Corona Beer?