By Dayna Mason

In my article from March 17, 2020 at the beginning of the pandemic, I wrote that the top two causes of death in the United States in 2017 were heart disease and cancer. That is still true today. In 2018 there were 655,381 deaths due to heart disease and 599,274 deaths due to cancer. As of this writing, COVID-19 has taken more than 370,000 lives in the US—and Acute Respiratory Distress Syndrome (ARDS) is still the primary cause of death among patients with COVID-19. So, where are we now with the pandemic and what’s changed in the last nine months?

More contagious, but not likely airborne or transmitted via surfaces

In the early stages of the pandemic, there was concern about surface transmission. However, research suggests this is unlikely. While SARS-CoV-2 can persist for days on surfaces, attempts to culture the virus from these surfaces have been unsuccessful. We are unlikely to get COVID-19 from touching contaminated surfaces.

In July 2020, a group of scientists was concerned that the existing safety recommendations were not sufficient. They believed there was the potential of airborne (transmission by microdroplets from person-to-person over long distances—greater than 6 feet) spread of COVID-19, based upon some unexplained indoor transmissions of the virus. If airborne transmission were possible, cloth masks would be ineffective, because they would not prevent inhalation of microdroplets (which are found in exhaled breath that can linger in stagnant air for hours). As of this writing, airborne transmission is still not universally recognized as one of the ways that COVID-19 is transmitted.

In September 2020 a new more contagious strain of COVID-19 was discovered—a mutation that allows the virus to bind and infect more cells. However, it does not appear to be more lethal or cause more severe symptoms. It’s easier to get, but not more deadly.

New drug treatments reduce mortality rate of COVID-19

The COVID-19 survival rate is 99% which sounds assuring, but if all 328 million US citizens contracted COVID-19, the 1% mortality rate would translate to more than 3 million deaths. A 1% mortality rate makes COVID-19 ten times more lethal than the seasonal flu and the third leading cause of death in the US.

Early in the pandemic the prediction was that approximately half of the population would contract COVID-19, resulting in up to 1.5 million deaths. As of this writing, more than 22 million citizens have tested positive for COVID-19, so if the vaccinations currently being distributed prove successful, we are far less likely to see the originally predicted 150 million cases.

In October of 2020, when President Trump contracted COVID-19, two new drug treatments were demonstrating success in the treatment of severe COVID-19 symptoms. The use of remdesivir accelerated recovery by about 31% (4 days) in patients with lung involvement and the use of steroids reduced the risk of death by one-third in those hospitalized.

President Trump received both of these drugs and was released from the hospital after only a 3-day stay.

COVID-19 is still a problem but the end is in sight

The latest complication identified in people of all ages with severe COVID-19 is abnormal blood clotting that can lead to a stroke or heart attack. The virus appears to unleash mysterious antibodies that mistakenly attack the body’s cells and promote clots in veins and arteries. A study in the journal Science Translational Medicine detected these clot-promoting autoantibodies in about half of the patients hospitalized with COVID-19. Some patients continue to experience ongoing blood clotting issues after recovery. More research is needed to fully understand this latest complication, but severe cases of COVID-19 are now commonly treated with anti-clotting drugs to reduce the risk of life-threatening blood clots.

Clinical studies show the two vaccines currently being distributed are 94%-95% effective in preventing severe COVID-19 symptoms after two doses.

Vaccines contain the same germs that cause disease. (For example, measles vaccine contains measles virus.) But they have been either killed or weakened to the point that they don’t make us sick. A vaccine stimulates our immune system to produce antibodies, as if we were exposed to the disease. After getting vaccinated, we develop immunity to that disease, without having to get the disease.

A study in November 2020 observed that approximately 80% of new COVID cases originated from indoor gatherings (especially those that were crowded and/or poorly ventilated) in places like restaurants, gyms and grocery stores—rating restaurants as the riskiest of the indoor environments observed.
Research has shown that fresh air and sunlight are toxic to viruses. So, if we insist on gathering, outdoors is still the safest place to be.

By slowing the spread or “flattening the curve” we have bought ourselves time. Time to discover drugs that reduce the risk of death due to COVID-19 and time to develop a vaccine that can prevent people from dying due to COVID-19. We are in the home stretch. While this pandemic is not expected to be significantly behind us until the end of this year, we have reason to be optimistic that the end is in sight. We just need to hold tight and continue to practice preventative measures to slow transmission, giving us more time to implement solutions that save lives.

 

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