Steve June 30, 2020
covid-19-outbreak-will-‘get-worse-before-it-gets-better,’-experts-say

June 30 (UPI) — The COVID-19 outbreak in the United States will continue to “get worse before it gets better,” but the situation might improve as clinicians gain a better understanding of how to treat the virus in the absence of a vaccine or a cure, experts said Tuesday.

Seeing an improvement assumes the public renews its commitment to “basic” approaches to containing the spread of the virus, including social distancing and wearing face coverings in public, according to Dr. Mark McClellan, a physician and economist who directs the Margolis Center for Health Policy at Duke University.

If the spread of the virus can be slowed, and the stress on the healthcare system caused by increasing numbers of seriously ill patients limited, the United States might be able to contain the outbreak within eight months, McClellan said during a conference call with reportersTuesday.

“This is not going to be forever,” said McClellan, who served as commissioner of the U.S. Food and Drug Administration and administrator of the Centers for Medicare and Medicaid Services under former President George W. Bush.

“I think things are going to be significantly better in terms of treatments we have available in a matter of months, [meaning] we may be able to relax a bit more,” he said.

Although there’s still no cure for COVID-19, the disease caused by the new coronavirus, SARS-CoV-2, and no vaccine that can prevent it, positive data has been released on two drugs — remdesivir and dexamethasone — that provide some help for patients who become seriously ill, McClellan said.

The “Recovery” trial in England tested low-dose dexamethasone in COVID-19 patients who required oxygen support with a once-daily dose of 6 milligrams, either by mouth or by intravenous injection, for 10 days.

Preliminary findings showed those who received the drug were 20 percent less likely to die from the disease compared to those who didn’t get the drug.

COVID-19 patients on ventilator support who took the drug were 30 percent less likely to die, the researchers said.

In a study conducted by the National Institute of Allergy and Infectious Diseases and released in April, remdesivir, an antiviral developed to treat Ebola, was found to reduce the median time it took a patient to recover from COVID-19 — to 11 days from 15 with a 10-day course of treatment.

“It’s even more important than ever not to overwhelm our healthcare systems because we can do more to save the lives of people having more serious cases,” McClellan said.

To avoid that, though, more young people need to increase their use of “basic steps” to prevent the spread of the virus, McClellan said.

These steps, he said, include practicing social distancing, wearing face masks, washing hands, staying home if symptomatic and self-quarantining if exposed to close contacts with the virus, McClellan said.

“If we can do that for the next six months, we would contain the pandemic,” he said.

Data released Tuesday by the U.S. Centers for Disease Control and Prevention suggests more must be done to promote those steps.

In a telephone survey of 350 adults with SARS-CoV-2 infection, 46 percent reported recent contact with a COVID-19 patient. Of those, 45 percent said the close contact was with a family member and 34 percent said it was with a coworker.

And, it appears that younger people are driving the spread of the virus now, with many of the new cases in places like Arizona, Florida and Texas — which reported 3,857, 8,530 and 5,357 new cases, respectively, on Sunday — among adults between 20 and 39 years old.

Most young adults are at lower risk for serious illness, but they still can spread it to those at high risk, McClellan said.

“We need to reframe” the messages around wearing masks and social distancing so that younger people “recognize how behavior choices impact those around them,” he said.

“Your behavior is not just about you, about your health, but also about the health of your loved ones and those around you,” he added.

Increased testing efforts across the country have not only captured more cases of the virus, but also caught them earlier in disease progression.

This means that treatment can be started sooner for those who need it, potentially reducing disease severity and spread, said Stephen Kissler, a research fellow of the Department of Immunology and Infectious Diseases at Harvard T.H. Chan School of Public Health.

“We’re seeing this rise in cases, but we’re probably catching it earlier, which means that we have a better chance of intervening effectively than we did earlier on in the outbreak,” Kissler said on a conference call Friday.

Further expansion of testing capacity — and increased use of point-of-care tests that provide results quickly — will be essential to effectively reopen schools and businesses, he said.

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