Martin Dubravec, M.D.  
     
     

The Hilltop Allergy Letter

Volume 19    Number 2

 

 

June – August, 2020


 


Introduction

              We welcome all new and established patients to our newsletter.  This is formulated four times a year to inform patients and the medical community with regard to new developments in asthma, allergies, and clinical immunology.  Please feel free to take this home with you and share it with family and friends. 

Lessons from the Coronavirus Pandemic

                We have learned a lot of information since the onset of Coronavirus infection in the United States this past January.  At that time, little was known about this virus other than information coming from China.  This information could not be considered accurate due to a long history of Chinese communist government releasing inaccurate information on previous epidemics that have started in China. 

                However, by March, reliable data was gathered in European countries, namely Italy, with regard to this virus.  Since the virus has come and is for the most part gone in the United States, we have learned much, but we also have a lot to learn regarding Coronavirus.  A few general points will be made here.

                The Coronavirus has been shown to have an approximately 70 day course of significant infection.  This is clearly been seen here in Michigan.  The first spike in cases was on March 19th.  The peak of cases  was noted on April 2, 2020.  This was most likely not anywhere near the full number of cases of Coronavirus in Michigan as we were severely limited in our testing capabilities at that time due to a lack of access to testing kits.  After April 2nd, the number of cases has declined in a very typical manner that has been shown in European countries where infection has occurred.  We have very few cases at the time of this newsletter. 

                We are still not completely certain as to how the virus is transmitted.  It is certainly reasonable to assume that this virus is spread through the area at least in part, since this virus tends to infect the airways.  Studies are conflicting with some studies saying the virus can last for days on a surface and others stating it cannot.  Studies have also shown that  asymptomatic patients rarely spread the infection (patients who have been found to have the virus and not have symptoms).

                Social distancing and the wearing of masks have been recommended by public health officials in an attempt to decrease transmission of the virus.  Research shows that neither of these maneuvers helps.  There were seven states that did not have lock-downs during this pandemic.  In those states, the number of Coronavirus cases per million residents were the same or lower than neighboring states that had lockdowns. 

                Two conditions are necessary for this virus to spread.  People who get this virus must be in contact with someone having a significant viral load, i.e., significantly ill people who have large amounts of viral production in their bodies.  Another condition is that there must be close proximity to infectious people for long periods of time in a closed environment

                The main reason why the virus spikes in cases and then goes away is due to the concept of herd immunity.  With herd immunity, many people are infected and their immune systems learn to fight the infection.  When they get exposed to the virus again, they no longer become infected as they fight off the virus.  The virus then cannot grow in their bodies and they are not able to transmit the virus to someone else.  This is what happened in New York City as well as the Detroit area.

                It is impossible to figure out how many people ultimately will be affected or die from Coronavirus.  It is also completely impossible to predict, with any accuracy, as to whether or not this virus will have another surge in cases this fall.  The models used to predict how this virus acts were way off and completely inaccurate. 

                It seems as if the public policy enacted to address this pandemic is not always lining up with the science.  Hopefully, we can move forward in developing appropriate personal and public responses to this viral infection.

                This virus is, like other viruses, treatable, rare, and can be dangerous in certain populations.  The most appropriate response to this pandemic is to approach it like we do influenza.  There is no doubt that this virus can be dangerous like influenza.  But as a society, are we willing to wear masks , isolate ourselves, and social distance indefinitely?  Where is the exit strategy out of the fear that has been placed on many people?  We can only stop fearing this virus when we start realizing that our risk of death from this virus is extremely low.  Over 99% of people will not get infected of Coronavirus and die of it.