To my Patients and Friends,
Here are some of the most recent COVID-19 news items.
Where we are now
News outlets and other organizations, including The New York Times, Johns Hopkins University and ProPublica have been diligently tracking COVID-19. Their data indicated that we have a way to go before we can declare ourselves to be on the other side of the COVID-19 pandemic. As of today, the U.S. Centers for Disease Control (CDC) has reported 1.99 million total U.S. cases (20,486 new) and 112,967 deaths (834 new). A number of states have begun relaxing social distancing guidelines at the end of April into early May. As a result, a concerning number of U.S. states have begun exhibiting increasing COVID-19 incidence and hospitalizations several weeks after initiating these efforts to relax social distancing. These include Arizona, California, Texas, Alabama, Alaska, Florida, North Carolina, South Carolina, and Vermont. A number of these states reported their highest daily incidence and/or hospitalizations over the past several days, which suggests that increased testing does not wholly account for the increased incidence. Additionally, many of these states were not hit as hard early in the pandemic, but they are now seeing an increasing incidence in connection with decisions several weeks ago to prematurely relax physical distancing. Of note: it’s still too early to correlate any increases in transmission with Memorial Day holiday gatherings or protests against racial and social injustice.
The Johns Hopkins CSSE dashboard has reported 2.03 million U.S. cases and 113,924 deaths as of 12:30 pm today.
Locally, Stamford Hospital has reported that the number of positive inpatients continues to decline. There is currently only one patient in the hospital with CIVID-19. This is great news for our region!
A number of companies are working diligently on a COVID-19 vaccine. Although a few experts have expressed cautious optimism that we will have a vaccine by the end of the calendar year, most agree that it will take at least 12-18 months for a vaccine to become available to citizens of the U.S and other countries. There is typically a significant time gap between the initial development of a vaccine and proof of its efficacy and safety. And to be effective in truly keeping the COVID-19 pandemic at bay for the long term, a viable vaccine will need to be made available on a worldwide scale… a big logistical challenge.
A number of patients have asked me what I think about travel. Some are trying to decide if it’s now safe elderly relatives to come visit here, while others are wondering if they can feel safe traveling to other locations. As more people resume traveling, it’s increasingly tempting to take to the air. However, I remind everyone that, in many other parts of the country, cases are on the rise (as discussed above). Some of these cases are bound to end up in airports and on airplanes, perhaps even in hotels and other facilities. It is for this reason, I continue to advise that travel should be limited unless absolutely necessary. We have already seen the impacts of premature relaxed social distancing in other states and in other parts of the world (see South Korea). In order to minimize the impact of a potential (if not probable) next wave, we will need to heed the scientists and continue practicing these safety measures to the best of our abilities.
The scoop on poop
We know that about 10-20% of COVID-19 patients present with gastrointestinal symptoms such as nausea, vomiting, abdominal cramping and/or diarrhea. And studies continue to demonstrate that the live virus can be shed in stool. Although this represents a less typical mechanism of spread, it is relevant and serves to highlight the importance of hand hygiene.
Airborne transmission remains the predominant mode of spread of COVID-19. This recent analysis published in Proceedings of the National Academy of Sciences (PNAS) confirms that wearing masks in public can dramatically reduce transmission rates and remains the most effective means of preventing the spread of the disease.
As many of you may recall, the U.S. Centers for Disease Control (CDC) recently reported that COVID-19 “does not spread easily” via potentially contaminated surfaces. The CDC then appropriately took a step back, indicating that, although we need more data on this, it’s indeed possible that the virus can spread via contact with surfaces. My advice (and that of most experts): continue to keep your hands clean and wear gloves when necessary.
And on a similar note…
Also in recent news there were comments made by Maria Van Kerkhove, PhD– a World Health Organization (WHO) epidemiologist- suggesting that spread of COVID-19 by those with asymptomatic disease is “very rare.” Shortly thereafter, she clarified her comments, indicating that “the majority of transmissions that we know about” occur via people with clear symptoms but that, as related to those who are asymptomatic or perhaps minimally symptomatic “we don’t actually have that answer yet”. Her initial comments drew a lot of criticism from many within the scientific community and most maintain that, until we know more, we should operate under the assumption that asymptomatic or minimally symptomatic people with COVID-19 may transmit the virus.
Disease prevalence in at-risk populations matters
Another impactful article, this time out of the U.K., discusses the disproportionate impact of COVID-19 on disadvantaged minority communities, especially black communities. In order to effectively contain the virus, we’ll need to focus on directing adequate resources to these “hot spot” communities. Native Americans have also been disproportionately affected. This problem affects us all
That’s all for now. Be safe, be optimistic but patient, be kind and be part of the solution! I hope you have a nice weekend, and I’ll see you soon.
For more information about Dr. Leibowitz’s concierge practice, please click here.