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Thursday, April 18, 2024

COVID-19: Experts set aside the truth from fiction

Almost 11 months into 2020, we asked our medical experts, once again, to revisit the gap between truth and fiction.

As the impact of COVID-19 progresses, and our understanding of the disease and its causes improves, the shape of online discussion has shifted. So, almost 11 months into 2020, we asked our medical experts, once again, to revisit the gap between truth and fiction. We asked them to address new myths that have only recently surfaced and persistent misunderstandings that are still circulating.

Covid death rate in the US

In the United States, COVID-19 cases are rising, but the death rate is relatively low — this means the virus is less deadly, and we shouldn’t worry. Infection case rates, hospitalization rates, and death rates often track each other. For example, as one goes up, the others go up, too. However, that is not always the case.

A lot depends on the overall health of the people in the community, how quickly and broadly they were able to access testing and treatment for the disease, and how prepared the communities are to handle the most severe cases.

Read more: New study reveals 40–45% Covid-19 carriers are asymptomatic

In many areas, we’ve seen a high case number but low death rate. The likely explanation is related to the fact that people in the community have better access to testing, which increases case numbers, and treatments, which decreases death rates.

Back when the COVID-19 pandemic first arrived in the U.S., very few communities had testing available. Now, testing is more accessible, plus we know a lot more about the virus, so we are able to treat it better, preventing severe cases that would lead to death.

The likelihood of contracting the virus

That said, we are seeing that younger people are developing COVID-19 (even in their 20s) and passing the virus on to others in the community. However, the likelihood of dying from COVID-19 increases with a person’s age and is more common in people with underlying medical conditions.

In fact, we are still seeing that people are dying and experiencing complications from the COVID-19 infection. We still do not have a cure or definitive treatment that works for everyone. We still do not have a clear recipe for successful treatment, especially in vulnerable populations, such as older adults who have chronic conditions, including asthma, diabetes, and cancer.

Unfortunately, because we are still learning more about the SARS-CoV-2 virus, we do not know what the long-term complications are for people who have had the infection and recovered.

Yes, we’re so grateful that these individuals have survived the infection, and we’re hopeful that they won’t have any long-term negative effects from the infection. However, we have seen that some people are still experiencing difficulties with breathing and other symptoms several months after the infection and hospitalization.

Read more: COVID-19: Breathing problems are the most common reason for returning to the hospital

We are also seeing cases where people who have had COVID-19 before are getting the infection a second time. So our best strategy is still to avoid getting the infection and prevent the transmission to others. Infections, such as the one that the new coronavirus causes, are opportunistic. They often explode and spread easily the moment we become relaxed and lower our guard.

The deadly nature of the virus

The virus’s deadliness was overstated in the first place. With any rapidly developing event, particularly one that has such global impact, it can be difficult to determine how deadly the disease really is. When it comes down to it, it is hard to wrap our heads around the statistics, such as case rates, hospitalization numbers, and death rates, when they are in the millions.

What other condition did I know of in clinical medicine where spending time in a small room with a person with an infection for just a few minutes could lead to an infection that could cause you to be hospitalized and put on a ventilator?

Part of the reason for this is that we have vaccines and treatments for the flu. These help prevent people catching the flu or, if they do catch it, help reduce the severity of symptoms

Before COVID-19, I would have said meningitis, pneumonia, influenza, etc. And as such, most doctors would never discount how deadly meningitis, pneumonia, or influenza can be.

What other infectious disease do we know of that has led to more than 38 million cases worldwide, with more than 1 million deaths over the course of 8 months?

Other viruses and diseases in comparison

In our modern age, with the medications and technology that we have, even Ebola, swine flu, or avian flu could not bring the world to a standstill in the way that COVID-19 has.

In fact, COVID-19 has killed more people (more than 218,000) in the first 8 months of 2020 in the U.S. than influenza has in the last several flu seasons. The Centers for Disease Control and Prevention (CDC) estimate that there have been 12,000–61,000influenza-related deaths annually since 2010.

What other infectious disease do we know of in modern medical history that has left the U.S. scrambling for ventilators because we were about to run out and would not have enough for people who needed them?

Read more: Speaking and breathing can spread COVID: study

Though COVID-19 has struck certain communities more disproportionately than others, it has also reminded us that we are all vulnerable. COVID-19 cases, hospitalizations, and deaths have affected many in our communities: young and old, and rich and poor.

We are very lucky that the SARS-CoV-2 virus does not kill everyone who has had the infection, but by most data measures, doctors like myself do not underestimate how deadly it has already been or how deadly it can continue to be if we are not diligent and conscientious about protecting ourselves, our loved ones, and others in our community.

Some people who have developed COVID-19 were fortunate because they either did not notice any symptoms or only experienced mild symptoms.

However, to say, as a blanket statement, that COVID-19 is just like a bad flu is dangerously inaccurate because it discounts the hundreds of thousands of people in the U.S. alone who have died from COVID-19.

It also does not take into account that we have seen reports of people who have experienced residual symptoms from their bouts of COVID-19, including ongoing respiratory problems, which we typically do not see in seasonal flu cases.

Covid versus white influenza 

Additionally, while influenza itself can be deadly, the seasonal flu does not typically have such high rates of hospitalization as COVID-19. Part of the reason for this is that we have vaccines and treatments for the flu. These help prevent people catching the flu or, if they do catch it, help reduce the severity of symptoms. We have neither vaccines nor consistent, dependable treatments for COVID-19.

We are also concerned that, as winter approaches, people might get both influenza and COVID-19 — either at the same time or one after the other. There are particular concerns that having one of the conditions may put someone at a higher risk for the other, and having both at the same time could be particularly dangerous, if not deadly.

Herd immunity is when the majority of people are immune to a disease so that it makes the spread unlikely. Herd immunity can be achieved through either vaccination or natural infection.

Read more: Moderna says COVID-19 vaccine in final phase of human trials

How to achieve herd immunity

In total, 70% of the general population (about 200 million people) will need to recover from COVID-19 to achieve herd immunity. However, this is conditional on whether the COVID-19 immunity is long lasting.

Unfortunately, we have not seen clear evidence as to whether contracting and recovering from a SARS-CoV-2 infection will lead to long-term immunity that is protective.

We are currently at 7.8 million cases in the U.S. and more than 38 million cases worldwide. We are not near the rates needed for herd immunity. Also, it is too early in this disease to know whether immunity is long-lasting. Therefore, it is not recommended to create mass infections to achieve herd immunity.

Last but not least, herd immunity only happens when the community is diligent about employing infection control strategies. When many people stopped taking the measles vaccine, the herd immunity and the control that we had over the disease disappeared, leading to outbreaks of measles in the states of Washington and New York in 2019.

As successful COVID-19 vaccines become available, it is important to keep an eye on when it would be appropriate for you to receive it based on your risk factors

We cannot assume that herd immunity, even if we did achieve it, would be everlasting. We must always remain vigilant and conscientious about how we protect ourselves, our loved ones, and our communities.

Social distancing and self isolation

Physical distancing is necessary to decrease the risk of transmitting a disease. In fact, we’ve been employing physical distancing for generations (if not for thousands of years as a human race) to prevent the spread of diseases.

It’s the basic logic behind why we instinctively avoid people when they are sick and why we ask people to stay home when they are not feeling well. All the while, our immune systems (the natural defense that protects our bodies from infections) have been continually developing and adjusting to our environment.

Research has also demonstrated that we can help our immune systems better fight off infection via controlled techniques, such as vaccination, which is more successful than allowing our immune systems to encounter illnesses in an uncontrolled way through random personal exposure.

Read more: New world order: Why South Asia will lead ‘Great Game’

How far are vaccinations successful

Even with vaccination, however, transmittable diseases, such as colds, flu, and pneumonia, are caused by viruses and bacteria that are highly contagious, so we work tirelessly to limit the exposure of healthy people to people who are ill.

This approach to infection control helps protect everyone in the community, including the people who are ill, because it preserves medical care and services for those who are sick. If we did not contain infections and everyone in our community were sick at the same time, our medical systems would be overburdened, and there would be a danger that people would not be able to get the medical care that they need.

5G is the fifth generation technology standard for broadband cellular networks. It is a type of radio wave that is digitized, so it improves the transmission and capacity of data. There is no evidence to suggest a cause-and-effect relationship between radio waves, their frequencies, and viral transmission.

Masks are a protective barrier that decreases the transmission of airborne diseases for both the person wearing the mask and the people around them. It prevents the transmission of infection through droplets from the mouth and nose. Notably, doctors and nurses wear masks in surgeries to protect all of us from infection during our operations and have done so for several decades.

A prolonged use of masks does not decrease oxygenation or increase carbon dioxide levels for medical professionals, and it does not cause either of those concerns in the general population today. Beyond healthcare, for decades, industrial and construction workers have also used masks to protect themselves from dangerous microorganisms and chemicals. Research has not shown prolonged mask usage to have negative effects on a person’s overall health.

No cure for corona

There is still no cure for COVID-19. However, healthcare workers and researchers are learning more about this illness every day, and there is accumulating evidence regarding which supportive treatments can help reduce the length and severity of illness.

For example, doctors often give steroids to critically ill people, and many are also receiving remdesivir, a medication that treats viruses. Conversely, evidence has now conclusively shown that hydroxychloroquine is not an effective treatment for COVID-19.

Clinical trials are still underway to determine the effectiveness and safety of other treatments, such as convalescent plasma. There has been exciting progress in COVID-19 treatment research, but we still have much to learn.

Read more: Which blood type is more likely to get COVID-19?

A silver lining to the corona virus

The good news is that, as we know more about the virus that causes COVID-19, we are better able to treat people with a SARS-CoV-2 infection so that fewer people die from it.

However, without a cure, it is still very important to do what we can to prevent the transmission of the virus, including practicing proper hand washing, wearing masks, and being diligent about physical distancing when in public.

There is still no cure, so we can help protect ourselves, our loved ones, and everyone in the community with our preventive measures. No. The clinical trial process required to identify safe and effective vaccines takes years in most cases. The development of a COVID-19 vaccine is no different. This timeline is necessary to determine how well a vaccine will work on a large-scale population basis.

It is also necessary to identify side effects that may occur weeks or months after a person receives a vaccine. Additionally, once a suitable vaccine candidate is identified, the companies will require time to scale up their manufacturing processes so that the vaccine is available for as many people as possible.

The COVID-19 pandemic has changed the world. As a result, the mental and physical health of the global population has taken a hit

Prioritise your patient

It is also important to remember that, even once the vaccine becomes available, it should first be given to those who most need it, including healthcare workers who provide medical services to patients who might have COVID-19.

In addition, priority should be given to those in the community who are most vulnerable to COVID-19 and its complications, including the elderly and those with chronic conditions, such as cancer, lung diseases (asthma or chronic obstructive pulmonary disease), or other conditions that weaken the immune system.

As successful COVID-19 vaccines become available, it is important to keep an eye on when it would be appropriate for you to receive it based on your risk factors.

This means that if you are among the populations that are at risk, you should be ready to get it when it is available for you, but if you have a lower risk, keep an eye out for when the vaccine is made available to the broader population. Antivirals fight the virus causing COVID-19, and steroids will help decrease the chances of an overzealous immune response, which contributes to some COVID-19 deaths.

Read more: Test and trace method helps curb spread of COVID-19: study

Steroids to the rescue

Scientists have shown that steroids reduce the severity and impact of a hyperinflammatory state, which is also called a cytokine storm. However, evidence supporting these treatments is not conclusive, and more research is needed to determine who would most benefit from them.

How well any treatment option works also depends on a person’s underlying medical status and conditions. An individual with serious preexisting comorbid conditions and a severely weakened health status will still have a difficult time fighting the infection, no matter how strong the treatment options are and how effective they have been in clinical trials in the general population.

The COVID-19 pandemic has changed the world. As a result, the mental and physical health of the global population has taken a hit. Our understanding of and approach toward the condition slowly morph as the months roll on, and we must maintain our focus on science.

Read more: 95% of people testing positive for COVID-19 show no symptoms: AKU

Medical research wins

Beyond politicians and “influencers,” it is medical research that will shepherd us away from this challenging time. Listening to those who know the deep science and have hands-on medical experience is our best bet to navigate our way through these rough seas.

Online Int’l News with additional input by GVS News Desk