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Thursday, February 25, 2021

An update on COVID-19 from Dr. Ross Schumacher

Hello my fellow Hoosiers. After many calls and texts from my local friends, I felt it prudent to write a quick, evidence based update on the Coronavirus.

COVID-19 is a virus that causes a respiratory illness similar to the flu but distinct in a few ways. Some of the data we have about exactly how virulent the disease is currently limited, because many different countries have dealt with testing for the disease in different ways. I think that South Korea is a relatively wealthy democracy with a modern health system (and a population similar to ours) so I will mostly refer to data from that region.

A COVID-19 infection starts rather innocently, with an average of 5 days of worsening headache, muscle aches, cough fatigue, then later fever. This is almost opposite of the flu, which typically has a sudden onset of high fever and cough within 1-2 days. After this 5 day period, the majority of people get better, however some (more on this later) do not. Those who are older (generally greater than 60, but a few random people younger than that) are at risk for the onset of a worsening immune reaction in the lungs, called ARDS (acute respiratory distress syndrome). A few of these patients inevitably pass away, at what rate they die is up for debate, but most level heads put it around 0.6-0.7% (the case fatality rate has likely been artificially inflated in America, due to lack of testing for milder cases and a generally older population in Italy that has been infected).

This brings us to a few common questions I have some answers for:

Is this worse than the yearly flu? Yes, for some people. The flu has a CFR (case-fatality rate) of around 0.1%, lower than COVID’s ~0.7%. For some reason, those who die from Coronavirus are almost all elderly (+65 year olds, typically with multiple chronic medical issues). Children under the age of 15 seem to be quite resistant to the disease, but we still aren’t sure why. 

Is this the apocalypse? No. H1N1 in 2009 killed an estimated 15,000 Americans and 500,000 worldwide, insofar outpacing COVID by 14,900 and 496,000, respectively. Infection rates in China and South Korea have slowed, with a declining number of total infections each day. Things can change, but these are the best available numbers we have right now.

When will the disease hit Rockport? By the time this goes to print (article written for The Spencer County Leader), some of you might already have it, albeit mildly. I expect we are underestimating the disease prevalence in America by about 3 fold due to lack of testing kit availability.

What can we do to prepare/prevent? Wash your hands at least twice a day with soap and water. Don’t go out to big public gatherings if you feel ill, especially if you have a cough. If you have a fever, go see your local physician. The N-95 facemasks generally only help those who are in direct contact with a known infected person, and large studies have shown them to be ineffective in helping stop community spread. General surgical masks are completely ineffective in stopping the speed of any airborne particle. Do not take any “magic cures”, essential oils, or helium baths in preparation for COVID, not because they will necessarily hurt you, but generally they are expensive and have no proven effectiveness. 

Should I travel to Italy, South Korea, Mainland China anytime soon? I would wait. 

When will we get a cure/vaccine? I don’t know. Remdesivir (an old SARS drug) has shown some ability to fight the virus in test tubes and is currently undergoing randomized clinical trials to determine efficacy in humans. There is lab data that COVID grows most rapidly in test tubes at 8 degrees celsius (about 49 Fahrenheit) so hopefully as summer comes community spread will drop even further. Warmer areas seem to be much less affected by spread at this time. 

Good night, good luck, we will get through this. 

-Ross Schumacher is an honors graduate from SSHS in 2009. He completed his MD at the Indiana University School of medicine and is currently a senior resident in Internal Medicine at UT Southwestern in Dallas, Texas.

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