The first case of covid-19 in the United States was detected on January 21st, 2020, in Washington state. Since then, many states have logged deaths from covid-19 infection, more of them happening in crowded cities and in crowded facilities like retirement homes. Several states have called for social distancing to reduce the risk of infection. Some states have not called for social distancing because the number of covid-19 cases in those states is smaller. Some people in the United States have called for a variety of tests for covid-19 but for different reasons.
Some want to use contact tracing whenever someone exhibits symptoms associated with the disorder and then tests positive for infection. They want to quarantine people who may have been exposed. But this effort can’t work to isolate all potential exposures because many people who can transmit the infection have an absence of symptoms or mild symptoms so that they don’t know that they are ill and don’t ask to be tested.
Some want to have antibody testing to determine how many people have already developed immunity to covid-19. People who have recently acquired immunity would be a potential resource for IgG antibody supplies to treat people who are sick if they would give permission for some of their antibody to be purified and transfused into a sick person. Some who advocate for antibody testing want to use IgG antibody to treat the sick.
Others hope to do antibody testing in order to suggest that people who are immune can go back to work. I have read that sewage testing shows covid-19 has become part of the waste stream, indicating a significant amount of infection in our population. Would antibody treatment show that many people have already gotten over infection with covid-19? When will covid-19 antibody testing become available?
On Mar 29th, 2020, President Trump said that social distancing as a public health measure should continue until at least the end of April. Part of the reason to begin social distancing was to protect hospitals from being overwhelmed by huge numbers of seriously ill patients beyond their ability to treat. Some have said that social distancing should continue until there is a vaccine that would make people immune to covid-19. But when that vaccine would be developed, if ever, is not known. Models that predicted higher death rates than what we have seen make some believe that this virus is less dangerous than once feared.
Some studies have already proven the usefulness of hydroxychloroquine combined with azithromycin to treat people infected with covid-19 (see previous post). According to one study this treatment is safe and effective with careful appropriate dosing given to a covid-19 positive patient soon after covid-19 infection causes symptoms of illness and the person tests positive. Presumably, people without symptoms don’t need this treatment. If we have a safe and effective treatment for covid-19, isn’t the health emergency over? Isn’t social distancing to protect hospitals not needed anymore?
As we look forward to tomorrow, I hope that we can rely on each other. I hope that political and economic motivations won’t cloud people’s judgement in deciding what policy is best for Americans. Many now suffer without employment in our economy as part of the policy of social distancing. I hope that if there’s a safe and effective treatment available in terms of supplies on hand and recommendations by doctors that we can use it and end the social distancing policy. Is there a practical reason not to end social distancing?
Addendum: On Thursday, President Trump’s broadcast announced measures that governors can use to reopen their economies and relax social distancing. If a state has a 14 day long decline in cases, that state can begin to reopen for business in a three stage process. In the first stage, people may be asked to continue staying at home as much as they can while businesses open their doors with the idea of having limited close contacts. During the first phase, schools will remain closed. This approach allows governors to make decisions about social policies that affect their state based on conditions they see there. These guidelines are an effort to respect the need for economic activity during a pandemic.
If you are curious about how we got to today’s political and economic package, I have written a book to help you do that titled, Political Catsup with Economy Fries and it’s available right now in both electronic and print formats at Amazon.com.