Best Laid Plans

To my Patients and Friends,

Here’s some of the latest news related to the COVID-19 pandemic.

Another reason to kick the habit

This may seem intuitive, but there is now evidence demonstrating a real link between recent tobacco use and higher risk for COVID-19.  Both traditional cigarettes and e-cigarettes seem to pose increased risk.

The hidden value of wastewater

In a previous installment, I discussed the ways in which techniques for the detection of the coronavirus in wastewater can be utilized as a means of tracking COVID-19.  Well, this approach seems to already be paying off.  A number of American colleges and universities have implemented plans to examine wastewater as a means of tracking the virus within campus populations, and some- including Syracuse University, Utah State University, University of Arizona and Colorado University Boulder– have already been detecting the virus via this method and have consequently been able to take appropriate precautions.  So stay tuned… these wastewater sniffers may be coming to a town near you!

The mood of a nation

A study recently published in JAMA Network Open has found that the prevalence of depression in the United States during the pandemic is triple what it was a few years prior.  The authors of the study suggest that we should anticipate an increase in mental illness as a result of the pandemic, particularly among at-risk populations.

All clear?

The journal BMJ open recently published some data indicating that the median time for viral clearance after infection is 30 days, and that clearance was slower in more severe cases of COVID-19.  The authors of the study preliminarily suggest that patients should consider being retested at least four weeks after symptoms resolve in order to reduce transmission risk.   However, there remain some questions as to the degree to which someone is actually infectious over the course of this prolonged recovery period.  It is likely that more studies will be needed for clarification on these matters.

Who’s on first?

One of the big questions being pondered by many in the scientific community has to do with deciding who will be first in line to receive a COVID-19 vaccine once one arrives on the scene.  It’s a complicated matter with many factors to consider.  Should they be front-line healthcare workers?  Nursing home residents? Military personnel at sea?  Prisoners?  Minority at-risk populations?  Should we share with other nations?  It’s safe to assume that, regardless of the timing of the eventual release of a vaccine, the supply chain will face huge logistical challenges (having to do with manufacturing, transport, etc.) that will force us to make some difficult decisions, at least in the early phases of distribution.  Dr. Arthur Caplan, a renowned expert in the field of Medical Ethics, discusses some of these challenging ethical dilemmas here.  It’s an interesting conversation and worth a listen.

Breathe a sigh of relief

According to a recent study published in the Annals of the American Thoracic Society, asthma does not appear to be a major risk factor for hospitalizations or intubations among those affected by COVID-19.  The authors theorize that the use of corticosteroid inhalers by those suffering with asthma may lead to a reduction in the number of receptors that are necessary in order for the coronavirus to enter our airways.

A sickle cell stickler

According to the CDC, those who suffer from Sickle Cell Disease are at higher risk for severe illness from COVID-19.  Sickle Cell Disease (SCD)- a group of inherited disorders characterized by the sudden change in the shape of red blood cells that can lead to devastating blood vessel blockages- affects approximately 100,000 Americans, the majority of whom are Black and therefore represent an at-risk population.  Scientists are now exploring whether the 3 million Americans who are carriers of only one copy of the gene and who are therefore at risk for more mild SCD symptoms may also be vulnerable to more severe COVID-19.  The researchers expect results in the next 6 to 12 months.

Disparities on the front lines

This article delves into the impacts of a potential DACA rollback on our front-line healthcare workforce, a contraction of which we can ill-afford in this age of COVID-19.  According to the authors of the report, “removing this population from the workforce would have a substantial impact on American health care.  DACA recipients often occupy hard-to-fill positions, and they can be well-placed to care for other immigrants. And with the U.S. health system having a disproportionately aged workforce, with many staff set to retire in the next decade, losing additional workers would compound an already looming staff shortage.”

Podcast of the week
Neuroscientist Matthew Walker, PhD wrote what many consider to be the book on sleep.  In this great podcast, he reviews some of the ways in which the COVID-19 pandemic has affected our sleep, both positively and negatively.  He delves into some of the critical implications of a healthy sleep pattern, particularly as related to our immune function.  It’s an engaging conversation and I encourage you to listen.

That’s all for now… please be safe during this holiday weekend.

And don’t forget to get your flu shots!

I’ll see you soon.