COVID: What we’ve learned one year later

The Means Report

AUGUSTA, Ga. (WJBF) – For the past year so many headlines have been focused on pandemics and politics. Now we look back – one year into the COVID-19 pandemic. What have we learned? How could we have been better prepared, and how are we better prepared for the next one. The Means Report is covering that in depth with a look back to a year ago and then by talking with Dr. Rodger MacArthur, an infectious disease physician with the Medical College of Georgia.

Brad Means: Things are constantly changing, especially the headlines every day when it comes to this pesky coronavirus. What are you telling the doctors of the United States? And what should the families know when it comes to their children? On the news each night, Doctor Goza, we say the really young and the really old, but that doesn’t cover all young people.

Dr. Sally Goza: No, and the coronaviruses, the COVID-19 is kind of an unknown. The CDC is still trying to figure out exactly what guidance to give. They’ve given a lot of guidance and good guidance. We know that it’s spread through droplets, and so covering your mouth when you cough. So we’re telling kids to cough into their elbows or into a tissue, and then throw it away. We’re talking about washing your hands with soap and water 20 seconds, sing the “Happy Birthday” song twice, and that will be enough time. And we’re actually trying to do that in our offices for the kids to see us doing it, so that they’ll know to do that. You can also use hand sanitizer, but it needs to be at least 60% alcohol. Those are the things you can do to really prevent the spread of this. But the other thing is, if your children are sick, keep ’em home.

Brad Means: If I hear somebody on TV say that this impacts the very young, among others, I’m gonna keep my baby home from daycare. I’m gonna live in fear. Is that smart?

Dr. Sally Goza: Really, we should not be panicking, you know? We have to wait and see what’s gonna happen. This virus is an unknown for the United States. We’re still trying to figure out where it is, how many people are infected, how it’s spreading. And so the CDC will be guiding us on that. And we actually are putting out things every day, as well, after talking to the CDC about what’s going on with it. Right now, we are saying, if you are sick, don’t send your children to school, stay home. If you think you’ve been exposed to the COVID-19, you need to call your doctor’s office to find out what you should do. And if you’re very, very ill and you need to go to the emergency room or to your doctor’s office, you need to call them and let them know you think you may have been exposed so that they can take precautions, so that other people aren’t affected by it. And so it’s a very scary time, but I really want to say, don’t panic. We need to be calm, we need to take care of this. And we will, and the CDC will guide us in that as we know more as it goes along.

Brad Means: The last time we met, as you so kindly reminded me, was to talk about Ebola, a threat that never really materialized, at least not in the United States like people thought. This one has.

Dr. Jose Vazquez: Yes.

Brad Means: Did you think this day would come?

Dr. Jose Vazquez: I did, I did. I mean, this is something that’s been going on since the beginning of time. We’ve had pandemics and epidemics for thousands and thousands of years, and they’ve been documented. So we knew it would happen. And we knew the smaller the world gets with air travel, the quicker any of these viruses from anywhere in the world will end up in the United States and North America.

Brad Means: You say it happens all the time, and that it’s happened since the beginning of time. How do we not notice it more? Are our immune systems just that great?

Dr. Jose Vazquez: Well, I think there’s some viruses that are around us that we don’t know of at this point in time that make us sick. It’s not uncommon for you to go to the doctor’s office and feel sick, and your doctor says, “Well, we think you have a flu bug,” and that’s it. And frequently, it goes away because we have what’s called herd immunity, which is, if it’s a low level virus, it produces antibodies and protects us from others that we have never been exposed to. Like this coronavirus definitely impacts us because it’s a brand new virus to our system. And because of that, everybody gets sick.

Brad Means: Brand new to our system. Do you think it’s real or man-made?

Dr. Jose Vazquez: No, I think it’s real. At this point in time, this virus was actually looked at about five or six years ago by some researchers at the University of North Carolina. And it looked like, it looks like a virus that’s found actually in snakes. So they actually published on this, so this could’ve been foretelling, really. Most of the virus comes from a coronavirus that was found originally in snakes. I hate to point to the term jumped, because viruses don’t jump, but somehow it’s actually made it into other animals. And from other animals, it made it into humans.

Brad Means: Well, it’s probably not the most productive thing to ask you about at this point, to say could we have gone back when we first saw the beginnings of this and done something about it. So I’ll just ask you right now, what’s the best way people can avoid it? And the reason I ask that question is because I think it’s to stay inside and never go out of your house. Some people think it’s to live life as normal.

Dr. Jose Vazquez: How about somewhere in between?

Brad Means: Yeah.

Dr. Jose Vazquez: Certainly the key, and everybody’s heard the term social distancing. You and I are about five feet, which is good. That’s a perfect distance for us to be. We know that these droplets travel probably four to five feet in that area, number one. Number two is, and I think more important for anything else, is if you’re sick, if anybody’s sick, anybody in your family is sick, please don’t go outside. Please don’t mingle with the population. Please don’t go to work. That’s how people get in trouble, and that’s how we have gotten these explosions and these episodes. For instance, the outbreak in New Rochelle, New York was started because of something that started in a church.

Brad Means: Well, everybody was anticipating this late afternoon news conference. They thought you were gonna shut down the state of Georgia. You did not. Why didn’t you shut the state down and are you still okay with that decision?

Gov. Brian Kemp: Oh, perfectly okay with it. I never had that on the radar at that point in time. I mean, that’s certainly a arrow in the quiver I have left if we need it. I’ve done a lotta research, followin’ a lotta data, talkin’ to the medical professionals at the Georgia Department of Public Health and many other individuals. And I didn’t feel like we were ready for that. In other countries that I followed, it didn’t necessarily work when they did that. In some ways, it made the problem worse by basically quarantinin’ families, forcin’ them to be together in their homes or apartments. And all of ’em ended up gettin’ infected by a family member that had the virus. And then they went to the hospital, and then it made the problem worse in some regard. So all the people that say that’s the only solution to the problem, they’re not really being forthright in looking at what happened in other countries and what the rates were, the infection rates, and other things. And that’s what I’m doin’ every day. But, you know, Brad, I gotta balance the needs of the whole state. Every community, as you well know, is a lot different from others around the state, dependin’ on where you are, whether you’re a great area like the CSRA or if you’re in Middle Georgia or South Georgia, or you’re the City of Atlanta, or you’re a small town like, you know, I was talkin’ to some elected leaders in Hazlehurst, Georgia in Jeff Davis County today. They don’t even have a case yet, and they’re tryin’ to figure out whether they need to shelter-in-place or not. So I took action that’s based on statewides. I’m supportin’ the communities if they wanna do more than that, dependin’ on what the situation they have where they are. But we also gotta look at the consequences of the hardworkin’ Georgians out there. We start puttin’ more people out of work, it creates revenue issues for the cities, and for the counties and for the state. And more importantly, for those individuals that are worried about buyin’ their groceries or medicine, and keepin’ a roof over their kid’s heads, and I have a great appreciation for that. We literally could have people losin’ everything they’ve worked their entire career for.

Brad Means: Dr. Coule, as of this broadcast, we’ve seen new restrictions put into place, especially shelter-in-place. Are we doing enough?

Dr. Phillip Coule: I think we are doing a lot. There are certainly some things that we could do better. And I applaud the Governor for giving the shelter-in-place order. I think it is needed. There are a lotta people that got the message, that have gotten the message of social distancing. But there, unfortunately, are still a lotta people that do not understand the importance of social distancing and do not understand the importance of limiting contact with other people. And so ratcheting this up a level hopefully helps convey the message of how important this is in order to prevent the healthcare system from becoming completely overloaded.

Brad Means: Yeah, that’s what I was going to ask you. I wanted to ask what happens to the virus if we stay home, but I guess the better question is, what happens to the hospital capacity if we stay home?

Dr. Phillip Coule: Right, so the whole purpose of measures like this is to limit the spread of the infection to the point that the healthcare system can handle the capacity. Because as the healthcare system becomes overloaded, and we’re not yet, but certainly other places in Georgia are being overwhelmed, as they become overwhelmed, then the quality of care could decline, for example, to the point where we don’t have enough resources or people are stretched too thin. And although we’re in pretty good shape here locally right now, it’s very important that we keep this under control and stay that way. For example, we’re already having patients transferred from Albany up to Augusta to our facility, because they just don’t have the capacity to care for them any more. With some of the areas near here that have not heeded warnings to not have large gatherings, et cetera, for example, in some cases, churches and funerals, that has a tremendous impact potentially on the spread of the infection, and needs to be avoided

Brad Means: Hmm, what a year it’s been. So what have we learned? We’ll hear from an expert on the pandemic when we come back.

Part 2

Brad Means: Welcome back to the Means Report. We do appreciate you staying with us as we do mark this somber occasion one year since the pandemic began. And now we welcome a guest who is no stranger to the Means Report or to the News Channel Six airwaves in general, because he has lived this pandemic up close and personal as one of our frontline workers for the last 12-plus months. He’s Dr. Rodger MacArthur. Dr. MacArthur is an Infectious Disease Specialist at the Medical College of Georgia at Augusta University. Rodger MacArthur, thanks for your hard work on behalf of our community, and thanks for being back with us today.

Dr. Rodger MacArthur: Oh, thank you, everyone. It’s a pleasure to be back.

Brad Means: Well, so let’s just start with a really general question, and look back to when this all started, give or take a few days last March. What do you think about the initial response back then, both really focusing more on the way our community handled it and the medical community handled it. Anything you would tweak or change with hindsight right now?

Dr. Rodger MacArthur: I would change just one or two things, thinking back a year or so. I think all of us were very surprised at how widespread the virus became. I certainly didn’t predict that it would be this bad, nor did anybody I know. In terms of changing anything, I think we closed the school on March 12th, and I think that would be about the same as I would do again today, so that was fine. I think those of us in Public Health, Infectious Diseases would have emphasized mask usage and social distancing more early on. You’ll probably recall that pretty much all the health officials initially did not think that masks were going to be effective. That, too, surprised a lot of us. So I think emphasizing that earlier is something I would have changed if I could, if I could have tweaked it.

Brad Means: I feel like masks are never gonna go away at this point. I’m not saying everybody’s gonna wear one forever, but don’t you think you’ll always be out and about and see someone wearing one?

Dr. Rodger MacArthur: At least for the next year or two, I think that’s probably the case. You know, I think if we could’ve all worn masks and socially distanced, we might have been able to keep restaurants open, hair salons open, as opposed to closing them. And I think we could have kept the schools open as well.

Brad Means: Yeah, but how do we know? How do we know what to do when a pandemic is just starting to break out? Can we take lessons from centuries ago when there were other pandemics? Or are those of any use to us in today’s times?

Dr. Rodger MacArthur: Unfortunately not. Technology is so much more advanced now than it was 100 years ago or so when we had the Spanish flu pandemic. Certainly, there are other virus epidemics or pandemics. The HIV comes to mind, but that is such a different virus than SARS-CoV-2, which is, of course, different than influenza virus. I really don’t think there’s much that we could have put into place based on records from back during the Spanish flu era.

Brad Means: Look, I know we’re not out of the woods yet. I sense, from my layman’s point of view, that there is light at the end of the tunnel that’s probably coming into view at this point. When we were in the thick of this, Dr. MacArthur, was your optimism ever tested that we’d get to this point?

Dr. Rodger MacArthur: No, I thought we would get to this point. I must acknowledge that I’ve been very impressed with the speed with which the vaccine has been developed. Now, that scared a number of individuals at first. They thought that we were rushing things through. And I shouldn’t say we to imply that we doing the work down here. But individuals that developed the vaccine had actually been developing this sort of vaccine for quite some time. And in that regard, everything was in place to very quickly ramp up production. I think the companies did an amazing job of putting tens of thousands of people into these clinical trials to show just how great these vaccines are, and more importantly, just how safe they are. And I’m really glad you asked the question, because I think it’s much more productive to look forward than to look backwards and say if only we had done this. if only we could have foreseen something. So I really like to look forward and be proactive for the next number of months, as long as the virus is still around to the extent that it is.

Brad Means: Yeah, let’s look into the future as much as we can when it comes to that vaccine. Yes, it was rapidly developed. Yes, the trials and the money, and everything the researchers needed was at their constant disposal. But the one thing that’s missing is time. We don’t know what this vaccine will do to us 10, 20 years from now. Will there be commercials from lawyers on television saying, “If you got the coronavirus vaccine, “sign up for this class action suit.” How can we trust it in that regard?

Dr. Rodger MacArthur: Well, I think that that’s not going to happen. The vaccine now has gone into hundreds of millions of individuals worldwide. And there really isn’t a signal that would suggest that, at least in the short-term, it’s dangerous or substantially harmful. And most of these vaccine-related side effects or adverse events occur relatively shortly after vaccination. So I don’t think we have to worry about what our body is gonna look like in 10 or 20 years. Also, of course, this is not a live virus vaccine. It doesn’t incorporate into our DNA. So I don’t think, well, I know we don’t have to worry about that.

Brad Means: Did I speak out of turn when I said that I could see the light at the end of the tunnel? Are we maybe leaving this behind slowly?

Dr. Rodger MacArthur: I believe we are. The concern now is for these variants. And, of course, that is reason for caution, a reason to perhaps temper some optimism. But we have to understand that viruses mutate. They are mutating from the moment they’re in our body. And some of these mutations are so-called dead-end mutations. They’re not compatible with viral existence. On the other hand, some mutations, and that appears to be the case for the UK B117 mutation, seems to make the virus fitter. It can out-compete what was around as wild-type virus for the last year or so. It’s estimated that by, I will say, the end of this month or April, over half of the new infections in the U.S. will be from one of these variants, probably the UK variant that’s circulating. But just because it’s fitter doesn’t mean necessarily that we need to worry. It certainly doesn’t mean that it’s going to be more dangerous, more deadly. And it does seem, at least for now, that individuals who have received one of the several vaccines that are out there have a really good response when exposed to one of these variants. So it does seem like there is some spillover protection, I think that’s the way that Dr. Fauci explained it the other day.

Brad Means: And one of your colleagues in the infectious disease world there, Dr. Jose Vazquez, told me recently that the HIV virus regenerates once every 24 hours. The coronavirus isn’t that hardy, is it?

Dr. Rodger MacArthur: No, as I said, viruses are viruses and they do mutate. This is the same general class virus as HIV, but still very different viruses. And HIV probably mutates a bit faster than SARS-CoV-2. And that can make it a challenge to keep up with effective treatments for it, in addition to having to think about different vaccines, booster, or something like that. But if we use the analogy of influenza, and again, influenza is a very different virus than either HIV or SARS-CoV-2, think about what we get every year. We got a new vaccine and it’s designed to work very well against the most likely strains circulating worldwide. Three or four of these strains are put into one vaccine. I can foresee something like that happening every year with the SARS-CoV-2 or COVID-19 vaccine.

Brad Means: Yeah, mutate, not regenerate. Mutate was the word I was looking for there. Talk about herd immunity, if you will, Dr. MacArthur, and how it works. Because going back, again, this was a speech that Dr. Vazquez gave to a civic group saying we needed to reach, if memory serves, 60 or 70% vaccination rate to hit herd immunity. We’re at about 20% vaccination rate nationwide. My question is, and you can work in the explanation of herd immunity into this, how come the virus can’t find those of us who haven’t gotten our shots, and just land on us and make us sick? How can it just go away if not 100% of us have shots?

Dr. Rodger MacArthur: It just makes it that much harder to be spread from a relatively few, or a low percent of people that have it, to those that are protected against getting it. This virus spreads differently than influenza does. It’s certainly not the case that every person that gets the virus will even infect one other person. Sometimes one person can infect 20. Sometimes one person can not infect anybody else. So the fewer individuals that are around susceptible to the virus, the less likely it is that the virus is going to have enough of us to thrive on and spread it around. And we just need to do what we can to get the virus to die out. We’re very much in a race. It’s a race against the virus spreading and us getting herd immunity or getting protected in one form or another. And speaking of herd immunity, it would appear that natural infection gives at least six months of protection, at least for those individuals under the age of 65. And it may be longer than that. Beyond that, we don’t know how much protection is. And the recommendation is, even if somebody has been infected, we want to give them the vaccine so as to develop a higher level of neutralizing antibodies, a higher level of protection.

Brad Means: Should we be worried about another pandemic any time soon?

Dr. Rodger MacArthur: Well, I think we have to get through this one. But I also think there will be additional pandemics, whether it’s an influenza pandemic, an unknown virus that we don’t know about yet, or, for that matter, some variant of COVID-19. As you know, there were previous SARS viruses. There was the original SARS virus and then there was the Middle Eastern Respiratory Syndrome virus that didn’t really involve many individuals at all in the United States. But viruses are out there. Viruses jump from one species to us to another species. Yes, we have to be vigilant. We have to keep our guard up. We have to have the infrastructure in place to respond to what will happen. We just don’t know how soon it will happen.

Brad Means: We only have about 45 seconds left, and I just wanted to use it to say thank you to you, and to ask you how good it feels to be in your profession. You all have really shined so brightly this past year. It’s gotta make you proud during such tough times.

Dr. Rodger MacArthur: I am very proud of my colleagues. I’m proud especially of the nurses who have been on the frontlines. I’m proud of our students who have gone out and helped vaccinate. They volunteered to vaccinate many. They’ve educated people. And it does feel good to be in this profession, but it also feels good to have life as normal again, to be able to go to a restaurant and eat, and have some degree of comfort that I’m not gonna get infected.

Brad Means: And amen to that. Rodger MacArthur, Infectious Disease Specialist, MCG at AU. Thank you to you. Thank you to the team members that you just mentioned. We appreciate all of you so much.

Dr. Rodger MacArthur: Thank you, Brad.

Brad Means: Absolutely.

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The Means Report first aired in January of 2009 offering coverage that you cannot get from a daily newscast. Forget about quick soundbytes -- we deliver an in-depth perspective on the biggest stories. If they are making news on the local or national level, you will find them on the set of The Means Report. Hosted by WJBF NewsChannel 6 anchor, Brad Means, The Means Report covers the topics impacting your life, your town, your state, and your future.