Diagnosing the COVID-19 surge

MYRNA BROWN, HOST: Coming up next on The World and Everything in It: coronavirus.

NICK EICHER, HOST: Many Americans hoped the worst of the pandemic was over when states began lifting restrictions in May. But as stores, restaurants, parks, and beaches opened for Memorial Day weekend, cases of COVID-19 rose along with it. Public health officials are now issuing dire warnings about what to expect in the coming months.

BROWN: Joining us now to talk about the latest developments is WORLD’s medical correspondent, Dr. Charles Horton. Good morning to you!

CHARLES HORTON, GUEST: Good morning to you!

BROWN: I’d like to start with a question we get fairly often from listeners. It has to do with reports on the number of COVID-19 cases. And they’re wondering whether that’s the metric we should focus on. Doesn’t the death rate or at the very least the hospitalization rate give us a better idea of how things stand in our fight with this pandemic?

HORTON: Yes and no, for a few reasons. How’s that for a straight answer?

Certainly in the long term, the death rate helps us to understand how we’re doing. In the shorter term, the hospitalization rate can help us to understand if we’re close to running out of resources. But patients who die from coronavirus usually don’t die right away. Often they are often critically ill for a period of weeks first. Moreover, if the virus spreads among the young, unfortunately that means it will soon spread among older people, too. That’s when the hospitalization and death rates probably go up, too.

BROWN: That is sad. For months, public health officials pointed to herd immunity as our way out of this. But recent studies have shown antibodies in people who have recovered from COVID-19 don’t last very long. That means they’re vulnerable to reinfection. What does that mean for our response to the disease and to the hope we’re placing in a vaccine?

HORTON: I’m actually not as discouraged by this as you might think, because I don’t think it’s likely that the immune system forgets completely. There’s a complicated answer behind that that’s a little much to get into here, but the bottom line is that if people do get reinfected, I suspect that it’s likely that they will have a less severe disease than if they’d never had COVID-19 in the first place. Or if they never had a vaccine in the first place.

BROWN: The disappointment over antibodies highlights something that seems to be key when talking about COVID-19: It’s a new virus, and there’s still a lot of things we don’t know about it. Now, Dr. Horton, you recently wrote a column for WORLD Magazine that focused on 10 reasons why people should take this pandemic seriously. We’ll link to that in the transcript so listeners can find it. But one of the reasons you listed was that we still don’t know what recovery looks like. What did you mean by that?

HORTON: We usually think of recovering from a disease as going back to how life was before it. We get a cold or flu, we cough and sneeze and feel miserable for awhile, we drink a lot of OJ and eat chicken soup, we rest, and then eventually it’s back to normal. Here, for a pretty substantial number of people, they survive, but they have long-term damage. And only time will tell if that’s a permanent thing. But we’re hearing from several sources that young patients are getting over coronavirus, in the sense that they’re no longer acutely ill with it anymore, but for example they may have no exercise tolerance. People who’d been athletes now lose their breath going up the steps. That kind of thing. It’s very much a different virus than things like colds and flu.

BROWN: Yeah, that’s disappointing. I’d like to end on a hopeful note, if we can. And we should remind everyone that while there’s a lot of uncertainty surrounding this disease, none of this is a surprise to God. He is still sovereign no matter how many difficulties we face here on earth. Doctors learn more every day about the best way to treat this disease. What are some of the latest developments, and is it possible to say whether those new treatment plans are making a difference?

HORTON: First off, that is an excellent reminder of God’s sovereignty! I take a lot of comfort in Romans 8:28, how all things work to the good of those who love the Lord.

Three COVID-19 vaccines are in large-scale Phase 3 trials, which are the final phase before the FDA can approve them. One more vaccine is also in Phase 3 trials, but I mention it separately because it’s not a coronavirus specific vaccine. That’s the BCG vaccine. If you’ve been to developing countries or, for listeners who are from a developing country, you might have seen it as the TB prevention there. It does help prevent TB, and it also seems to boost immunity more broadly. Could it help against coronavirus? An Australian team thinks it might, and I’m very curious what they’re going to find. 

On the drug front, we’ve learned that dexamethasone, which is a cheap, widely available steroid, does help severe cases, although it doesn’t help in minor ones. This is not the same as the inhaled steroid some of you have written to ask about, but fear not: there’s a study going on for that one too, with an Oxford team.

It’s a really exciting time to be following medical technology, because it’s unfolding so quickly in front of us. Stay tuned!

BROWN: Yes, yes. We will, indeed. Dr. Charles Horton is a practicing physician in Pittsburgh and WORLD’s medical correspondent. Dr. Horton, thank you so much for joining us today!

HORTON: Thanks for having me here!

(AP Photo/Elaine Thompson) Edwin Hernandez has his temperature checked as part of a screening for coronavirus symptoms at a portable testing site for maritime workers at Fisherman’s Terminal Wednesday, May 27, 2020, in Seattle.

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