This first wave to COVID-19 is slowing down from its second peak. It remains to be seen whether this represents a temporary dangerously high plateau or a trend toward truly reduced numbers. We have still lost 3,700 Americans in the last four (4) days and the USA death toll is now approximately 182,600. Diagnosed cases in our country number over 5.9 million. The infection rate remains over 10% in 12 states and over 5% in a total of 29 states. The CDC has projected that we will reach 200,000 deaths by September 19 and the IHME (Washington U.) estimates a tragic toll of 317,000 by December 1. The latter organization further estimates that 67,000 lives come be saved if 95% of Americans would wear masks when they are outside of their homes and not able to socially distance.
At our last update we reported that the use of convalescent plasma had been placed on hold by the FDA due to a lack of proven effectiveness. This potential therapeutic has become a political football in that convalescent plasma was given an emergency use authorization (EUA) four days ago, with glowing reviews, after the President had voiced dissatisfaction that it had not yet been approved. The following day the Commissioner of the FDA, Dr. Stephen Hahn, backtracked on his 24-hour old characterization of the benefits, though not rescinding the EUA. This reversal of course came on the heels of objections to the EUA by the Infectious Diseases Society of America. This physicians group, which represents the infectious diseases medical experts, noted that the President’s and Commissioner’s characterization of the data in terms of effectiveness was one, overblown, and secondly the EUA will make it more difficult to complete the scientific studies necessary to actually prove the effectiveness.
A second potential politically driven controversy regarding one of the agencies responsible for protecting our health involves the CDC and its newly issued (8/24/20) testing guidelines for COVID-19. These new guidelines say that if a person has no symptoms then they do not need to be tested, even if they have been in close contact with a person with documented COVID-19 disease. This is scientifically the wrong approach according to many epidemiologists and infectious diseases specialists. They akin this change to “flying blind’ as it disregards the science that has been proven to be effective at fighting this dreaded disease. We know that asymptomatic and pre-symptomatic people make up about 40% of the COVID-19 cases. If you fail to test, then these folks will not be identified, and they can spread the disease unimpeded. The push to get citizens to wear masks is based on the need for each of us to protect those around us just in case we might be one of those unbeknownst spreaders. Not to mention that contact tracing is worthless without the testing of people without symptoms. Again, medical experts raised their voices and the Director of the CDC, Dr. Robert Redfield, issued a clarification stating that “testing may be considered for all close contacts of confirmed or probable COVID-19 patients”. This explanation did not get policy back to the previous position of testing all close contacts. Multiple states have announced that they will disregard the new CDC “guidance” and follow the direction of their own healthcare experts which adheres to the previous guidelines.
Unfortunately, public confidence in our government is being strained by the politicization of our public health organizations. At this time, we do have some power over this virus if we will just WEAR, WASH, WATCH, and avoid large crowds. We await a safe and effective vaccine. The problem is that the trust that the public has in our public health agencies responsible for delivering us this vaccine has been eroded by interference by a political agenda. We can only hope that the medical scientists stay true to their oaths and give us a vaccine that has been adequately tested.
Clyde E. Henderson, MD
Cincinnati Medical Association