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What You Need to Know About COVID-19 Right Now (mid-July 2020 Edition)

The Coronavirus Pandemic continues around the world and in the United States, with states in the American South and Southwest right now reporting the highest numbers of cases. While states in the North, Midwest and Northwest United States don’t have as many cases, cases there are still simmering, waiting for the reopening plans to go sideways and allow the virus to make a comeback.

Meanwhile, the entire country is locked in yet another social and political battle over school re-openings. Some school systems want to continue online learning. Others want full, in-classroom learning. Others want a mix of both types. And the people in the White House want a full return to classes, with seemingly nothing in between.

Good stuff.

The Coronavirus Continues to Be a Virus

One thing that has not changed about the coronavirus is that it is still a virus. It is still in a lipid envelope that can be disrupted through soap or alcohol sanitizers. Hand washing is still highly effective at preventing infection because hand washing washes away and kills the virus, reducing the chances that you contract it by bringing it into your nose, mouth or eyes through contaminated hands.

That dirty motherbleeper…

Contrary to what conspiracy theorists want you to believe, the virus is not some result of an experiment gone awry. It is no one’s Frankenstein monster. Based on the genetic analysis of the virus, it came about through natural processes. That said, many of those processes could have been avoided. The increased encroachment of humans into wild areas for housing, food and raw materials is a big concern. It causes what we call “spillover” events.

The virus is still relatively heavy and will not travel long distances on its own. This is why we continue to recommend social distancing of at least six feet (two meters). Because coughing, sneezing, yelling and singing can launch the virus further as it grabs on to your spit, mucus or cells, we also recommend cloth face masks. While they will not 100% protect you from infection, they will prevent you from launching the virus is you’re one of the many people who carry the virus asymptomatically.

Speaking of Symptoms

At the beginning of the pandemic, there were three symptoms we were focusing on: fever, cough, and shortness of breath. Since then, we’ve learned that there are a variety of other presentations of a coronavirus infection (COVID-19 is the disease caused by the infection). The definition of a case has changed to include more symptoms: body aches, chills, loss of smell, loss of taste, sore throat and headache. Of course, these symptoms alone don’t guarantee that you’re infected with the virus, so you need to see a healthcare provider if you or someone in close contact with you has had these symptoms.

Only a lab test can diagnose the infection.

Speaking of Lab Tests

There are now more lab tests available not only in the number of tests but in the types of tests. Initially, there were only PCR (polymerase chain reaction) tests available to detect the virus RNA. Now, we have tests to detect the virus antigens (bits of protein or fat or sugar) on the virus surface. We also have tests for antibodies against the virus. Soon, there will be tests for immune markers other than antibodies that our bodies make against the virus.

We need to take all of these tests with a grain of salt, however. The PCR is still the “gold standard,” the test that if positive means you are infected and if negative means that you are likely not. If that test is positive, however, we do not know how infectious you are, or if you’re likely to develop the symptoms and complications — and now sequelae — of the infection. What we do know is that you need to go into isolation for at least ten days while your close contacts go into quarantine for fourteen days.

The other laboratory tests are still not quite there with regards to their sensitivity and specificity — the two measures by which a healthcare provider or public health practitioner can be certain that a positive is a true positive or a negative is a true negative. They’re either not there because their technology is new, or because — as is the case with antibody testing — the virus is new. There is some good evidence that antibody tests might be picking up antibodies against the other human coronaviruses and not this human novel one, leading to false-positive results.

But We Really Don’t Need Masks, Right?

For the life of me, I can’t figure out why the allergic reaction to wearing masks. Some people say it is a form of tyranny, an overreach of government toward its citizens. Others believe that this pandemic is not happening, so wearing a mask in public would be an acceptance on their part that it is happening. Then there are those with, seemingly, a form of oppositional defiant disorder who don’t want to just because.

Whatever the case is, we need to understand that they are in the minority. Yes, they threaten the rest of us who decide to follow public health recommendations and wear masks, but we shouldn’t feel like we — the ones who follow reasonable recommendations — are the weird ones. You — yes, you — who follows recommendations, gets your children vaccinated, washes your hands… You’re the “normal” ones (for lack of a better term). We outnumber them.

There is no vaccine against the Dunning-Kruger Syndrome.

Speaking of a Vaccine

A vaccine against this coronavirus is still months away. Even with recent news that participants in a trial made a lot of antibodies after being vaccinated, there is no guarantee that those antibodies are specific enough to grant immunity… Or that they will be around long enough to allow us to reach herd immunity.

I’m not pessimistic about this, actually. I’m quite optimistic that we will have a good vaccine in 2021. It’s just that this rush to publish results by press release rather than peer review is going to get someone hurt. Not only might we end up with a Dengue vaccine-type of fiasco, but we could end up with people plunging a lot of money into a company selling vaporware when it comes to a vaccine.

Still, if you’re curious and want to track the progress of vaccine studies, check out this tool from The New York Times.

In Conclusion

So this is where we are right now. Cases on the rise in the South and the Southwest; the virus is still a virus that hygiene, cloth fase masks, and social distancing can defeat; a vaccine is months away, but it should be here in 2021; and you are not in the minority when you see so much attention being given to people who won’t listen to reason.

Let me know if you have any questions.

Categories: Blog

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René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

3 replies

  1. A few notions.
    First, yes, the virus is somewhat massive, but snot is a tad more massive and carries multiple viral particles. Still, one would need another article to explain that even halfway to casual readers, so I get it.

    PCR, great for finding sequences – it’ll even detect dead viral residue shortly after an infection is over, again, a technical niggle, not a really big deal. They did PCR for my test, while I was hospitalized for hypoxia, requiring 5 LPM to maintain a preferred SPO2 level. Bloody thyroid decided to throw a storm, BP was hypertensive crisis on steroids, pulse akin to a rabbit’s pulse rate, lungs had modest infiltrates and atelectasis, just to avoid boredom. I’ll not go into suspected AAA, which previously was modest dilation.
    So, essentially, to Goober things down a lot, a type of CHF. And literally, the words, “Thank God it’s only CHF” did depart my lips, to much mutual jocularity, given the context.
    I’ve lost around 1.5 – 2% SPO2 level, largely I suspect, due to anemia that was also noticed and I have a lab full of tests to ascertain where any red cells are being lost or destroyed, alas, my car is toast and I’m still looking for a cheap car to replace it. Still, maintaining a 95 – 98% SPO2 for a 40 year smoker is respectable. Get the RBC levels up to more normal levels, it’ll likely spring right back.
    Yeah, that virus would fold, spindle and mutilate me, my wife being diabetic and having her own medical train wreck conditions, the same.
    Masks for sure for us! The models I finally selected and received have a pouch to add an N-95 filter, should that improbable necessity ever arise and honestly, I don’t anticipate intubating anyone again.

    I am concerned as to vaccine candidates as well, what naturally helps eliminate infection appears to be a fairly high molecular weight antibody, which had a worrisome low half-life and reinfection had occurred in multiple, well documented cases.
    I have some grave reservations in that area. What good is a vaccine, in a low compliance environment, that lasts at best, a pair of months?

    Checked with our daughters, down in Delaware County, PA. There are precisely one of three chances that the grandkids are going back to a prematurely opened school.
    Slim chance, fat chance and no chance.
    Any official that objects, I’ll happily have a short talk on a long subject and my infamous NCO glare remains an ability of mine that quailed civilians and even superior officers. That and an artful tongue, well, they’d regret being born and I’d have to call 988 for them, on the way out of the door.

    I also saw mention online of a store manager having an argumentative customer, who refused to mask, then ripped the mask from the store manager’s face, to spit in it.
    Given my risk profile, I would consider such an action attempted murder and react accordingly, with every military skill I attained over nearly three decades of service. The minimum is one elbow going the wrong way and one knee going the wrong way, if a weapon comes out, the individual won’t survive to regret that unfortunate decision.
    One upside is, in this township, we do have community policing, so no law enforcement is about to come in guns blazing, but more likely to ask WTF, Wiz? We’re known to them, largely due to community policing and simple proper human values endemic in that department. We arrived in the area, literally, flat broke. An officer arrived, asked a few questions, told us where to park where an objection would not be logged.
    Then, took us to the market to get a few snack items and water (I had a little food left and was starting my new job at the time in a couple of days), to only return an hour later with a friend to give us more provisions.
    Two days later, I got a pay advance to cover lodging and food.
    Since, on relief again, PUA relief, so I’m bringing in nearly as much as I normally earn and food bank excess items I put at a local cheap hotel’s vending machine and watched a brisk exchange Pollyanna trade ensue.
    Note to self: Put more food up there tomorrow, while out to get necessities.

    Interesting York County, PA observations. A few weeks ago, Rutters customers were an average of 2/3 unmasked, despite company guidance (and refusal to enforce mandatory mask usage, as apparently, they don’t enjoy property rights that every other individual or corporation enjoys within the Commonwealth. Yeah, copped out and became objectionable as a risk location for us), now, it’s well over 2/3 masked.
    So, the fear of infection, if not God, has infused itself within them. A month ago, wearing my mask earned me dirty looks in a Rutters, now, nary a glance.
    Still, the majority of food purchases are from a Giant supermarket that’s only two miles away and I’ve got a fine collapsible shopping cart. Enforced pedestrianism isn’t a chore for me, despite needing a cane to prevent a fall if one knee collapses, it simply keeps me in shape!
    Did it in Louisiana, when my alternator failed on my first week on the job.
    Hope to keep on doing it when I’m 80, at a minimum, working on a billion years here. 😉
    Although, I’m scratching my head, why does Giant manage to enjoy sufficient property rights to enforce mandatory masking of customers, while Rutters does not?
    Oh yeah, prostituted “will”. Trust me, Rutters has heard my views and knowledge, via never confirm, nor deny some things. 😉

    Liked by 1 person

    1. If I had it my way, schools would think very long and very hard about reopening. They don’t seem to have good plans. They had ten years since the last pandemic to plan this out. It is very worrying that institutional memory is not more than ten years old.

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      1. Honestly, without trebling the cost of our schools, I have no idea how one could gin up a school that is safe from contagious diseases being passed around like they were candy. Kids aren’t exactly the most sanitary creatures on the planet!

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