ID experts take ‘sobering’ look back at 6 months of COVID-19 pandemic
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The death toll from COVID-19 has surpassed 200,000 in the United States and could rise dramatically by the end of the year if mitigation efforts do not improve, said Jeanne M. Marrazzo, MD, MPH.
“The bottom line is that it doesn't matter what side of the aisle you are on politically — the numbers are the numbers. You can't argue with them, and they are not going in the right direction,” said Marrazzo, an Infectious Diseases News Editorial Board Member and director of the division of infectious diseases at University of Alabama at Birmingham School of Medicine.
Marrazzo spoke during a press conference this week hosted by the Infectious Diseases Society of America about the past 6 months of the pandemic. She said rising case counts are “not an isolated phenomenon” — 27 states are showing an uptick infection rates.
According to Marrazzo, barriers to improved COVID-19 treatment that were present at the beginning of the pandemic — shortages in PPE and testing kits, lack of consistent mask-wearing guidance from the federal government — are still prevalent.
She also noted the fatigue and “staggering emotional costs” faced by ICU and ER nurses, lab workers and other health care workers who are constantly at risk for infection.
“I really hope we can pull together to recognize that we can change the trajectory if we work together,” she said.
John Lynch, MD, MPH, associate professor of allergy and infectious diseases at University of Washington School of Medicine and associate medical director of Harborview Medical Center in Seattle, said that despite challenges, the scientific community has managed to make significant “inroads” in regard to the virus.
“It is quite sobering to think about where we started and where we are 9 months later,” Lynch said. “This is a novel coronavirus — we didn't even know about this problem until December of 2019, and given this particular strain and the recognition that we are less than a year in, what the scientific community has learned about this virus and the disease itself is significant."
According to Lynch, the greatest risk for transmission of SARS-CoV-2 comes 2 days before and 4 to 5 days after symptom onset. Lynch said sustained close contact plays a major role in transmission, and that constrained spaces such as bars, indoor workplaces and prisons are at high risk for spread of the virus.
He suggested that keeping 6 feet apart does not guarantee a person’s safety from infection.
“There is nothing magic about 6 feet. We use this number because it seems to be the area in which a lot of respiratory particles are at higher density,” Lynch said. “It does not mean that 6.5 feet or 7 feet or some distance is perfectly safe. It is just a way that we have learned has been a good and effective way to communicate the highest risk groups and categories.”
Despite major developments in treatment, Lynch noted there is still “a lot to learn” about the virus, including the dose needed to infect someone, COVID-19’s long-term effects, and optimal treatment and vaccine strategies.
Regarding aerosolized spread of SARS-CoV-2 — in headlines recently because of a deleted note on the CDC website — Lynch said there are currently “no good data” to confirm airborne spread of the virus.
Lynch said state travel restrictions are “probably not” effective because of a lack of a national approach to travel management and a reliance on self-reporting from travelers.
Marrazzo called state-controlled travel restrictions “wishful thinking” and said a lack of enforcement hinders their potential to be helpful. She emphasized the importance of pregnant women being included in upcoming COVID-19 vaccine trials.
“If we don't have a vaccine that is safe for women who are pregnant, want to get pregnant or are breastfeeding, we don't have a universal vaccine for health care workers,” Marrazzo said.
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