Coronavirus

CDC

CDC

COVID-19 has been declared a pandemic by the World Health Organization.

As 2020 is winding down, the number of people who have personally been affected by COVID-19 Coronavirus has grown tremendously.

With cases statewide at approximately 162,000 with 1,679 deaths reported as of mid-week, the numbers in the county had risen to 795 on that day. In the month of November alone, the county added more than 500 positive cases of the Coronavirus.

That number is nearly almost 10 percent of the county’s population and doesn’t include the hundreds or thousands who have been quarantined for exposure — or the people who have had a family member, friend or co-worker that’s been affected.

In March, when the pandemic officially hit the United States, there were very minimal local cases – it was a big deal when that first case appeared in the county and when another one was added. Now we are approaching a time when dozens of cases are being added weekly in the county.

Healthcare resources at the Hiawatha Community Hospital and the Health Department are stretched thin, along with those working at care facilities and in other places deemed essential. Many businesses are shortening hours, requiring appointments or just doing business over the phone or internet. This also includes city and county businesses and some local banks.

It’s apparent the Coronavirus is here to stay and our respite in the summer was just that – a break before things got really serious. However, being cautious all these long months has helped hospitals obtain the supplies they needed and allowed healthcare officials the time they needed to put plans in place for an eruption of the virus.

And November seems to be the month for this to happen. The virus has even hit hospital staff as 29 members of the staff had tested positive during the month, compared to only a total of 14 as of Oct. 31.

Hospitals all over the nation are filling up with COVID patients and Hiawatha Community Hospital has reported the option to transfer COVID patients to a higher level of care is not as available as it once was.

This is why healthcare officials are backing the mask mandate – currently in effect in the county until Dec. 7 when the county commission will review once again. The City of Hiawatha also has a mask mandate in effect, with no published ending date as of now. Healthcare officials are advising social distancing and washing of hands multiple times, keeping gatherings very small and with family members who are familiar to your household.

Healthcare officials are also trying to dispel a few myths that have transpired as more of the population has battled COVID and are in recovery.

One of those myths is that a patient who has entered the recovery stages of COVID-19 has a developed an immunity and does not need to worry about taking precautions.

Local healthcare officials and national experts say this isn’t necessarily so. While a body can develop antibodies to a virus following a battle with it, the length of time these antibodies can be present to protect a recovering patient is still up in the air. If a patient has a mild case of COVID, they may develop less antibodies — which means a shorter term of protection. Or immuno-compromised people may develop fewer antibodies.

“While people may be considered ‘immune’ for 90 days that is a fluid term and can give people a false sense of security,” said Ronna Montgomery, Director of Quality, Risk Management and Infection Prevention at Hiawatha Community Hospital. “Every person is different and every immune system varies. KDHE does not currently recommend retesting within the 90 post-recovered window or testing asymptomatic people at this time. Obviously statistics change based off of data obtained and as every new day comes, there is more data to add.”

As the United States is essentially less than a year into fighting the virus, the data hasn’t been gathered and studied much in comparison to other viruses such as Influenza and strep throat.

“That is why it is important that people continue to wear masks and mitigate their own droplet spread to others,” she said. “We are also not yet seeing a large amount of influenza but this will change and we don’t have a crystal ball to know when that will peak. So far, we as a community need to remember that many viral infections spread via droplets and it is important that everyone continue to wear masks. They could be asymptomatically spreading other viral illnesses (such as Influenza A and B). COVID is one of many of the viral illnesses that we have to worry about.”

HCH Laboratory Manager Lindsey Hooper, MLS (ASCP)cm, who has spent countless hours studying the virus, said patients will “shed” the live infective virus up to 14 days typically after the virus onset. This “shedding” is done through waste – which is why the Hiawatha waste water had COVID present during a Kansas Department of Health and Environment testing late last spring. Hooper said with some patients – those who are immunocompromised – have had a live virus recovered up to 20 days following the onset of the illness, but noted this has been rare according to her studies. It’s possible to recover residual, likely non-infective virus RNA for up to 12 weeks after onset of symptoms from recovered patients. She said that by retesting a previously positive COVID-19 patient, within 90 days of initial illness onset may result in another positive result, but that it may not necessarily represent an active infection. She said the Center for Disease Control currently recommends retesting within 90 days for patients who previously tested positive, only if that patient becomes symptomatic again and there is not another diagnosis.

Antibody production typically occurs following an infection or immunization with a pathogen. She said this is the body’s natural response to an invasive virus in order to slow the progression. The presence of these antibodies – along with other specific cells to that virus — can help fight the onset of a virus reoccurrence.

“It is the combination of antibodies and cells that helps to clear the pathogen and also helps should you ever become re-infected with the same pathogen again,” Hooper said, but issued a caution. “The thing to remember is that antibody levels typically decline over time. Your body may produce more if you are re-infected with the same pathogen but it is not guaranteed.”

“Each person’s immune system functions differently so re-infection with the SARS-CoV-2 virus is a possibility and showing antibodies after an infection doesn’t mean you should discontinue use of preventative strategies such as mask wearing, good hand, hygiene and social distancing,” she recommended.

Dr. Julie Rosa’, MD and provider at Hiawatha Community Hospital, said it was her understanding that COVID antibodies last approximately 90 days, but recommended still adhering to safety precautions during this time, regardless of a perception of “safety.”

“The more severe the infection, the higher the number of protective antibodies that are present,” she added.

Dr. Rosa’ alluded to a bigger picture that has at times been forgotten.

Dr. Rosa’ said that some people have a perception that they are safe and so therefore, don’t feel they need to take precautions, such as wearing a mask and social distancing is “wrong motivation that I feel our county has/is struggling with.”

“The point of all of the precautions is the “one another”-ness that should characterize our lives,” she said. “We think of others ahead of ourselves; we think of the big picture because our community’s health matters over our convenience. To not wear our masks or follow precautions does many dangerous and selfish things like giving others a false sense of safety when they imitate us or condoning breaking the mask mandate or just flaunting the health of others. I understand the culture shock of COVID, but feel that if we don’t model safe behavior for others, we have failed at our larger calling. That should be true of all of us, whether we are in healthcare or not.”

What do the national experts say? Dr. Roy Chemaly, M.D., and infectious disease and infection control expert at Anderson MD Cancer Center at the University of Texas provided a list of “Do’s and Don’ts” in a recent article on the website www.mdanderson.org.

No. 1 on the list is to NOT assume you’re immune to the coronavirus, even if you’ve had a confirmed COVID-19 diagnosis before, he said.

“This disease hasn’t been around for a full year yet, and we’re still learning about it,” Chemaly said in the article. “So, even if you had a severe case and made a full recovery with no complications, we don’t know if natural immunity will protect you or for how long.”

He said whether immunity stems from a vaccine or actual exposure to the virus, experts speculate it may still only be temporary. That means people would likely need a booster shot every year to maintain enough antibodies to provide on-going protection. He also added that cancer patients and other immunocompromised patients may not develop antibodies at all — either to natural infection or to vaccinations. So, it’s even more critical not to assume you’re safe from reinfection if a person would fall into one of these groups.

No. 2 on his list is “DO keep taking all the recommended COVID precautions” by social distancing, wearing a mask, not attending large gatherings and washing hands frequently.

It’s also crucial to protecting others if there’s even the slightest chance you might still be contagious, he continued.

“Take the same precautions you would as if you had not had COVID-19,” Dr. Chemaly said. “Avoid large gatherings of people, and act as if reinfection is still a possibility. Because it might be.”

Montgomery also advised that anyone who has not been vaccinated for influenza should do so soon and recommended that the older population should also inquire with their physician about the pneumonia vaccination and shingles vaccination and what timeframe they should look at getting those.

During the course of studies, the Coronavirus has changed and recommendations change as more data is gathered. It is recommended reviewing the CDC and KDHE websites for the latest information on SARS-CoV-2/Covid-19 information, recommendations and updates.

Information obtained in an article by Cynthia DeMarco at the MD Anderson Cancer Center website contributed to this article. For her full article and interview with Dr. Chemaly go to https://www.mdanderson.org/cancerwise/recovered-from-covid-19-coronavirus-am-i-immune-4-things-to-know.h00-159385890.html.

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