Health Advisory: Coronavirus
Important Health Information: Coronavirus
COVID-19 Update: August 30, 2021
Is COVID-19 a “Forever” Problem in Our Area?
By: Juanita A. Archer, M.D.
To approach the answer to this question, this article will review COVID -19 (Coronavirus 2019) in the USA, its diagnosis, its treatment followed by a discussion of what today’s science suggest is on the horizon for COVID -19 in the USA with emphasis on the District of Columbia, Maryland and Virginia area.
Since December 2019, COVID-19, one of the most contagious and deadly viruses known to man, has caused more than 624 thousand deaths in the USA; 11,632 in Virginia, 9,907 in Maryland, 1,151 in the District of Columbia. This Severe Acute Respiratory (SARS) virus, originally defined in Wuhan, China, moved from human to human around the world with occasional cases being reported in domestic animals. Like other viruses, COVID – 19 is not a living organism thus, it must infect living cells in order to survive and reproduce. The virus defined in December 2019, recently named the “alpha” variant, and used spikes on its surface to stick to human cell surface proteins that permitted it to get into the human cells. With increased human-to-human transmission, the virus mutated so as to achieve more efficient and more deadly access to human cells. The deadly variant in the USA today is “the delta variant”. This variant has learned how to alter the human cell wall proteins so as to make the cell wall “liquefy “, i.e. the cell destroys its own cell wall thus, cells coalesce and the virus multiplies in a pool of cellular material with no cell walls to stop it. Unvaccinated people become the hosts for this deadly variant to live, grow and change into even more deadly forms of COVID-19. While the virus does this in the mucous membranes of unvaccinated people, the infected unvaccinated person may be completely asymptomatic and transfer the mutated variant to someone who becomes deadly ill from it. The elderly and immune deficient are more susceptible however, it should be remembered that children harbor viruses and are also very susceptible.
The USA leads the world in testing for COVID – 19 thus, we still have one of the highest rates of people identified as positive for COVID – 19 (August 18, 2021 case rate: USA = 37.3 M; Va. = 729K; Md. = 483K; DC = 52,843K) Testing is done by either PCR or Antigen tests. PCR is the most specific for identifying COVID – 19. It is a rapid test that measures pieces of the virus. The Antigen test measures pieces of the protein that make up the COVID- 19 virus not the virus itself.
The best treatment is PREVENTION
Prevention of this deadly virus is accomplished by:
Vaccination – any one of the three available vaccines (see side effects below) plus:
- Wearing a 3 layered mask that fits snuggly over the nose and is tight on the cheeks– the N 95 is one of the best/or double mask in presence of increase new Delta variants in community.
- Washing hands with soap several times per day. Wash as long as it takes to sing one verse of the “Happy Birthday” song.
- Use Hand Sanitizer that has at least 70% alcohol frequently. (Do not let young children drink or lick off of hands.)
- Distancing from non-family members/ avoid crowds
- Taking Vitamin D – at least 1000 IU if your physician approves it for you
- Drink enough water, Get adequate rest and exercise.
- Environmental cleaning of surfaces with Lysol or other antiviral substances per CDC recommendations (https://www.cdc.gov/Coronavirus/2019-ncov/community/disinfecting-building-facility.html)
Vaccines: The important thing to remember about the efficacy is that all the vaccines prevent death from COVID -19. Efficacy refers to degree any illness is prevented. The three vaccines currently approved:
1. Pfizer- BioTech – highest efficacy (95%)
- Moderna mRNA – efficacy = (85% - 90+ %)
The above two are messenger RNA viruses that give cells instructions on how to make and use spike proteins to fight the virus. VERY FEW SIDE EFFECTS FOR MOST OF POPULATION: SLIGHT MALAISE, PAIN AT SITE OF INJECTION ARE MOST COMMON. TWO INJECTIONS approx. 6 to 8 weeks apart. CDC is to approve a 3rd vaccination a booster, for immune compromised and elderly people with chronic organ disease. This is to be given 8 months after the 2nd injection. Pfizer’s vaccine received full FDA approval on August 23, 2021.
3. Johnson & Johnson – efficacy = 75% to 85%
This is a viral vector vaccine that does not contain a live virus. It uses a harmless adenovirus to create a spike protein that the immune system responds to, creating antibodies to protect against COVID-19. Side effects are same as above however there have also been 100 cases of temporary body paralysis called Guillain-Barre’ Syndrome associated with this vaccine, occurring within 42 days of vaccination. This is a one-dose vaccine.
Other therapies are available for active COVID -19:
- Anti- inflammatory agent (Actemra) approved for hospitalized patients
- Three monoclonal antibodies that bind to spike protein of Cov-2 and inactivate it were approved for use early in COVID – 19. Regeneron is one of the best known monoclonal antibodies. These are not advised for the Delta variant. They must be used early in other variants of this disease, i.e. within days after the diagnosis.
Other anti-inflammatory agents and vaccines are being developed. New styles of effective masks are also being developed. The age for vaccination is being lowered. During the coming year, these are likely to be available. Newborns or six-month old infants are likely to be offered the vaccine within a year.
The answer to the question of whether or not COVID- 19 is a “forever” disease may depend on how many members of our population gets vaccinated and take preventive steps to stop it from spreading and mutating. Are you doing what you can to stop it from killing us today and tomorrow?
- Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD (March 2020). "How will country-based mitigation measures influence the course of the COVID-19 epidemic?". Lancet. 395(10228): 931–934.
- Cox C, Krutika A, COVID -19 is the number one cause of death in the U, S, in early 2021; Health & Wellbeing. February 22, 2021
- CM Allen et al. Guillain-Barre’ syndrome variant occurring after Sars-CoV-2 vaccination. Ann Neurol 2021 June 10 (epub)
August 19, 2021
The CDC recommends the following commonly known avoidance actions:
1. If you are sick, it is best to stay home from work, church, etc., to avoid spreading germs and infecting others.
2. Wash hands frequently for at least 20 seconds.
3. If unable to wash with soap and water, use fresh hand sanitizer that has 60% to 90% alcohol. Note that alcohol evaporates rapidly.
4. Avoid touching your face, eyes and mouth.
5. Cover your nose and mouth with tissue if sneezing or coughing.
6. Clean surfaces often with antiviral, antibacterial disinfectant.
7. Until the weather gets warm, limit close contact to include hugging and kissing.
8. Maintain good health habits to include sleeping 6 to 7 hours a night; healthy eating, drinking water and exercising appropriately and taking vitamins recommended by your physician.
What I Am Doing For the Upcoming COVID-19 Coronavirus Pandemic
The current projections for its expansion in the United Sates are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
- No handshaking! Use a fist bump, slight elbow, elbow bump, etc.
- Use ONLY your knuckle to touch light switches, elevator buttons, etc. Lift the gasoline dispenser with a paper towel or use a disposable glove.
- Open doors with your closed fist or hip; do not grasp the handle with your hand unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
- Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
- Wash your hands with soap for 10 to 20 seconds and/or use a greater than 60% alcohol-based sanitizer whenever you return home from any activity that involves locations where other people have been.
- Keep a bottle of sanitizer available at each of your home's entrances and in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
- If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more.
Recommended items to have in stock:
- Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump and all other outside activity when you come in contact with contaminated areas.
NOTE: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you, but all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only affects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
- Stock up on zinc lonzenges. These lozenges have been proven to be effecting in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharnx. Use as directed several times each day when you begin to feel any cold-like systems. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharnx. Cold-Eeze logenzes is one brand available, but there are other brands.
James Robb, MD