As of this writing, we have over 15 million confirmed cases of COVID-19 worldwide and over 4 million cases here in the U.S. Those numbers are staggering – and not what we expected when I first wrote on Sedgwick’s blog only six months ago about the novel coronavirus as an emerging threat. Where do we stand and what do we think our reality could be in another six months? It’s hard to predict.
This virus is frustrating for many reasons, some of which involve the symptom profile. None of us want to believe we could be infected, and the commonality of the symptoms allows people to convince themselves they are suffering some unrelated, minor ailment and can continue with everyday life. They therefore spread the virus because they do not believe they need to isolate as it seems their symptoms are not severe. For the record, here is the list of symptoms and – even if you think you have allergies or a sinus infection or a migraine – out of an abundance of caution please protect your family and community by staying home:
Fever, cough, shortness of breath or trouble breathing, fatigue, muscle aches, headache, congestion or runny nose, sore throat, rash on feet/toes, new loss of sense of taste and smell, red eyes or signs of eye infection, upset stomach, loss of appetite, vomiting and diarrhea
Antibody testing: It is important to know that if a person is tested for antibodies within the first week after developing symptoms, antibodies may be very low or not present at all. Scientists are not sure how long and what type of antibodies are available in the system. It is believed if you had a severe illness the antibody levels are higher and last longer in the system. Studies from other coronaviruses show that there are two types of immunity:
- -“Sterilizing” which prevents infection and might not last too long in the body
- -“Protective” immunity which can prevent or lessen the symptoms but is believed to be longer lasting in the body
There is still so much to learn and investigate. For employers who are considering antibody testing, there should be awareness that a person can still be shedding virus and have antibodies present; it is not the ultimate safety clearance.
Vaccine development: A vaccine, which usually takes years to develop, is well underway, with hundreds of companies racing to develop one. There are 140 potential vaccines being tracked by the World Health Organization(WHO). Last week, the New England Journal of Medicinepublished an article with a preliminary, promising report of a small-scale trial for the Moderna-produced vaccine candidate (mRNA-1273) that has not had any limiting safety concerns. The side effects were similar to flu-like symptoms. This week, we heard about additional positive results from the University of Oxford vaccine study. Trials are indicating that the approach being evaluated is safe and provokes a human immune response.
But there’s still far more ground to cover before a vaccine is approved and released. The clinical trials are what takes the most time and are most important. Many new vaccines can cause serious side effects which have to be weighed against actual disease. The goal for a vaccine would be to provide enough worldwide doses to create herd immunity – enough people must be immune to stop the spread. The United States is investing billions of dollars with large drug manufacturers to ensure we can have access to the number of doses required. It will be important to overcome the stigma against vaccines before one is available so people will be open to vaccination.
Virus testing: Testing for the novel coronavirus has been an issue in the U.S. since the beginning of the outbreak. At first, there were not enough tests and only the sickest could be confirmed. Then, based on region and phase of infection rates in specific states, more tests became available to help abate the curve. Now that populous areas of the country are spiking again, it is important to know that tests are only between 34% and 80% accurate, according to the WHO. In the busiest areas, the results are taking weeks to return and therefore making contact tracing and avoidance of virus spread very difficult.
Quarantine: This is a simple strategy. If you are exposed to someone who is positive for COVID-19, you can become positive any time up to 14 days from that exposure. A negative test means very little in these circumstances. It is still possible you could develop symptoms and convert to positive. It is important that people understand a negative test will not clear you from quarantine.
Masks: I am often asked about individuals who believe they cannot wear a mask. Masks should be considered a piece of personal safety equipment. Medical societies are supporting the use of masks in public for everyone except those with severe facial burns where it would be too painful to the skin or those under the age of two or those who are incapacitated and unable to remove the masks themselves.
Pulmonologists have gone on record stating that even those with asthma and COPD should wear masks. They stress the importance of finding a mask that is comfortable and not too tight. They even suggest a break in period of wearing it at home until they can work up to the required time wearing it.
The bottom line? Stay safe, wear a mask in public, socially distance from others and wash your hands. Let’s commit to each other to do our part to stop the spread of this virus.