Tuesday, October 20, 2020
Looking Ahead to a New COVID Spike While Addressing Long Haulers
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Muffy Ritz, sporting her new Vamps mask, it looking forward to the upcoming Nordic season, even though COVID has left her with lingering problems.
   
Thursday, September 24, 2020
 

STORY AND PHOTO BY KAREN BOSSICK

COVID GRAPHS BY PAUL RIES

Catching her breath has never been a problem for Muffy Ritz as she’s traveled the world competing in bicycle races across America, Nordic ski racers and scads of other competitions.

But this summer she finds herself struggling to catch her breath after some athletic endeavors—something she attributes to a week-long bout of COVID in mid-March.

 
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Paul Ries’ COVID graph shows a spike in Blaine County since the schools reopened. At least a few Blaine County School District teachers and students have tested positive in the past couple weeks.
 

“My sense of taste and smell is just slightly beginning to return,” said Ritz, who planned to get a pulmonary function test this week. “I can taste bleu cheese. But cilantro, which I used to love, now tastes like soap.”

Doctors are seeing concerning long-term effects among so-called long haulers who are complaining of symptoms four to six months after they’ve had the coronavirus, a member of the Governor’s Coronavirus Task Force told those attending a virtual question-and-answer session offered by The Idaho Statesman a few days ago.

“All too often I hear people characterize this illness as either a ‘mild and asymptomatic get-over-quickly disease’ or, if you’re old, a ‘go in the hospital and die disease.’ But there’s a lot in the middle,” said Dr. David Pate, former CEO and President of St. Luke’s Health Systems.

Dealing with symptoms six months after the virus is not a common manifestation of respiratory viruses like cold or flu, Pate said. While men tend to be more apt to die from the virus, women have a slightly higher incidence of long-haul syndromes.

 
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Idaho’s seven-day moving average of cases shows a downward trend but Dr. David Pate predicts another spike.
 

And that’s especially true for females in their 30s and 40s.

“Often, someone who is very, very active and in good shape tells us they’re completely exhausted after climbing one flight of steps. They can’t focus. They have memory problems, trouble catching their breath. They have palpitations, a fast heart rate. Some say they started getting better after four months. Others are having problems six months out,” Pate said.

Doctors speculate it may be due to direct damage the virus has done or, perhaps, indirect damage from what immune system is doing. They’re seeing new blood clots form even while a patient is undergoing imaging. People in their 30s and 40s are suffering major strokes. And athletes given health screenings before they return to sports are showing evidence of myocarditis, an inflammation of the heart muscle. One European study identified that in 60 percent of those it was screening.

Even if they heal, they could develop a scar that can trigger arrythmia and other problems, Pate said.

ANOTHER SPIKE AHEAD

Pate said he fears a third spike in Idaho coronavirus cases as the state heads into fall. Idaho is trending down from its second but it still has more cases than its first peak in late March and April and there are more people in ICUs now.

“As we trend down, I’m certainly hoping people don’t get complacent. We’re still worse than we were in March and April,” he added.

Pate said it will get worse again because of kids returning to school and college and bars closed by the second spike beginning to reopen. Moving indoors as the country heads into the cold and flu season  also ups the risk, he added.

“Kids are a big factor in the spread of colds and flu. We don’t know if that’s the case with COVID. But it is the case for other coronaviruses so I suspect that will be the case with COVID,” he said.

Some researchers have speculated that kids haven’t been big spreaders of COVID because they don’t cough as vigorously as adults. But add a cold on top of COVID and their cough could become more transmissive, Pate said.

“PLEASE get your influenza vaccine, and get the whole family an influenza vaccine,” he added.

It takes two weeks from the time of the shot to gain protection against the flu. Pate said he gets his in mid-October to ensure it lasts through the flu season.

“It’s hard to know how long the flu season will last—you can see it as late as April or May.”

TESTING TO IMPROVE

Pate said Idaho’s abysmal start testing for COVID was a direct result of failures in the federal government. The state had trouble getting testing machines, swabs and reagents, and it took time to send tests to commercial labs out of state.

But Idaho is creating its own solutions now with the help of public-private partnerships. It’s setting up seven labs throughout the state that will be able to process a couple thousand tests a day. And it’s hired a testing coordinator to oversee the program, which should be in place by the first of November.

WHO TO TRUST?

Pate said it’s been “quite shocking” to hear the tape recordings of the President that showed he has purposely downplayed the severity of COVID since the beginning.

“He was not honest with us. There are ways to say how serious the virus is without inciting panic. You can say, ‘We’ve got a problem here, but here’s what we’re going to do,’ ” he said.

Pate added that the World Health Organization, Centers for Disease Control and the Food and Drug Administration have let us down, as well.

“Dr. Stephen Hahn is a novice at running an organization like the FDA and he succumbed to political pressure. You can’t do that.”

The good news, he added tis that there are physicians willing so speak up and cry foul.

Pate said he tries to get information from those who don’t have a conflict of interest and he looks to see whether the information matches up with clinical studies.

“I also look to see if someone is willing to admit when they’ve been wrong. I was wrong when I said that we shouldn’t wear masks. I had to revise that as new evidence came out.”

A VACCINE BY YEAR’S END?

Vaccines are not where pharmaceutical companies typically make money, but pharmaceutical companies have a tremendous incentive to invest in in COVID vaccines because everyone in the world needs one, Pate said.

More than 150 are being developed and tested and new technology means that some of the vaccines look different. Moderna, for instance, has one that cannot infect you and is easier to produce than those that went before.

Many of the vaccines have advanced to phase three trials, which is the last step, and data from the first two phases has been encouraging. It’s possible the FDA may give emergency use authorization to one or more of these, which means it will rely on the company’s data rather than do its own tests to accelerate the process.

The federal government has funded production of promising vaccines so a few of these could roll out soon after approval. The vaccines will then go to the federal government, which will distribute the vaccines to the states. The states will then distribute the vaccines first to high priority groups, such as health care workers, first responders and high-risk individuals.

The vaccines will require two shots—with the second one administered a month after the first.

“It’s possible we could start seeing some vaccines by the end of the year. I don’t think enough will be available to distribute to the rest of us until spring,” Pate said.

Also:

  • Pate said he does not feel comfortable in groups yet, but he feels safe taking a drive in a car, going for walks and sitting in his backyard. Being indoors with people comes with a risk. And, no, garages don’t have good enough circulation, even with doors open.
  • There are two factors that will indicate whether a school can stay open. One is community spread—the more people who test positive the bigger the problem. The other is how well thought out operation plans are.

    “The biggest mistake I see are plans that are not detailed enough. That don’t address things like the risks in the school yard before schools starts.”

  • Children who are susceptible to things like strep throat, bronchitis and asthma may actually do better this winter than previous winters if schools have good health precautions in place such as wearing face masks.
  • Idaho has not had problems with outbreaks at gyms although some states have reported such cases. Distance is even more important in gyms than other indoor situations because, if someone’s breathing heavy and fast, they’re going to transmit more virus. Thirteen feet of distance is a good rule of thumb, along with cleaning gym equipment.

 

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