More than 500,000 people have died from COVID-19 worldwide with the 10 million mark for confirmed cases also crossed last week.
It’s been nearly half a year since the novel coronavirus came to the United States. Many projections, facts and guidelines have shifted since the first few months of the pandemic.
“We definitely have let our guard down,” said Dr. Richard Medford, UT Southwestern Infectious Diseases expert.
The start to the summer tourist season around Memorial Day saw the permitting of large gatherings and the country has seen more than 2,000 protests, and riots ravaging the country, all of which have had the chance to be “super-spreader” events for COVID-19.
“It’s not (over), as the last few weeks of record-setting numbers have made painfully clear,” Dr. Sonia Bartolome of UT Southwestern Medical Center said. “Now is the time to be vigilant about taking precautions, especially with July 4 coming up and summer travel in full swing.”
Every single state has reduced restrictions in the past month. Twenty six of the 50 states have shown an upward trend of new cases in recent weeks.
In states where there wasn’t an enormous first wave of the virus and fewer restrictions put in place like Florida, Texas, South Carolina, Arizona and to a certain extent Wyoming, a recent uptick of cases has occurred.
The U.S. is averaging nearly 15,000 more new cases per day than it was two weeks ago. Nearly 130,000 Americans have died from COVID-19. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he expects cases to rise and fall throughout the U.S. for another year.
Real or fear?
But should residents be concerned about cases alone, or should hospitalizations draw the real concern? In Park County, there are currently 41 active cases but no hospitalizations. Only one case has been hospitalized here since the pandemic began.
Vice President Mike Pence recently attributed the increase in cases to an increase in the amount of testing made available.
Between May 9 and June 22 there were 271 tests given in Park County, 367 were performed before that. In addition, 1200-1500 tests were given out over the last three weeks at Powell Valley Healthcare.
Testing has gone up noticeably in Wyoming in the last month with about twice as many tests administered on a daily basis than the daily toll for the previous two and half months.
But in Park County the number of new cases has greatly outpaced the increase in testing. Until late May there had only been two confirmed cases, separated by more than a month. The second of these cases was the only one requiring hospitalization so far.
There were at least 10,009 cases and 23 deaths from the influenza flu in Wyoming during the 2018/2019 flu season, for a mortality rate of 3.98 per 100,000 people. Since March, the coronavirus has led to 1,487 cases and 20 deaths, meaning there may be a lower chance of contagion than with the flu, but a higher risk of mortality for those who do get the virus. The U.S. death rate for the coronavirus is 39 per 100,000, while the mortality rate for the flu is two per 100,000.
Risk of the flu is also lessened by there being vaccinations.
Wearing face masks can reduce the risk of spreading the coronavirus by 97%, according to a review of 172 studies performed by The Lancet, and a Texas A&M study determined they are the most effective way of reducing human transmission of the disease.
“COVID-19 specific studies of mask use are being completed faster than they can be published,” Billin said. “They show evidence that masks are the single most effective public health measure that can be employed.”
Although masks do little to prevent a wearer from getting the virus themselves, it can serve as an indirect reminder not to touch your face and acquire bacteria in that way.
Face masks were not recommended at the beginning of the pandemic because at that time experts did not know how easily people could spread the virus before symptoms appeared. People who have COVID-19 or suspect they do should remain indoors and away from household members and pets as much as possible.
Even those who are asymptomatic can still spread the virus. Although the elderly or those with pre-existing health problems are most likely to get COVID-19, those under 40 years old can still get it, with nearly half the hospitalizations in the Dallas area less than 50-years old.
Asymptomatic people account for 40-45% of all infections. The CDC estimates 40% of coronavirus transmission is occurring before people feel sick.
“These discoveries led the U.S. Centers for Disease Control and Prevention to do an about-face on face masks,” the Mayo Clinic in Minnesota reported.
After advising against using masks as recently as early March, the CDC changed its guidance for widespread use of simple cloth coverings, to prevent asymptomatic spread. Due to the national shortage of N95 and surgical masks, the CDC is only advocating the general public use cloth masks. Cloth masks can be reused and made cheaply at home using items like T-shirts and bandannas, with no sewing required.
Face masks do not trap enough carbon dioxide to be harmful and the CDC recommends wearing cloth coverings in public settings and when around people who don’t live in your household, especially when 6 foot social distancing is difficult to maintain. Teton County recently made wearing face masks mandatory in public spaces.
Based on its data, UT Southwestern Medical Center reports states requiring public mask wearing since April have avoided anywhere from 230,000 to 450,000 new cases, and in New York alone 66,000 cases were averted between April 17 and May 9 because of restrictions implemented.
Mortality rates from COVID-19 have increased rapidly each week since May 9 in countries that did not mandate wearing face masks, in a study of 194 countries.
Cloth face masks should not be worn by children under 2 years old and those who have pre-existing breathing problems, are unconscious, incapacitated or unable to remove a mask without assistance. Experts say pre-existing breathing problems must be severe in order for wearing a face mask to cause a health risk.
Clear masks are acceptable, but face shields have not been proven to provide any protection from spray or respiratory particles.
N95 masks, considered superior to surgical masks, block 95% of particles .3 microns or larger, the Mayo Clinic said. Because these devices don’t completely prevent a carrier from spreading the virus, some places have still banned them. They must be specially fitted to the user and are reserved for medical use.
The Mayo Clinic reported countries that implemented face masks, social distancing, testing and isolation early on in the pandemic have had success slowing the virus.
Contagion through the spread of water droplets through the mouth and nose is still considered a primary source of transmission, while spreading over surfaces is not considered as likely as before.
An indoor space with no wind is likely a high-risk facility for spread of the virus. Even communicating between others can spread the virus through a fine mist of droplets.
In the early days of the virus there were great shortages of tests throughout the country and many requirements needed to be fulfilled in order to be allowed to take one. Now, the U.S. is on pace to have a million people tested per day. The more tests taken, the greater surveillance capability of the virus.
Nobel Prize-winning economist Paul Romer suggested that if 30 million tests were given per day, the country would be able to completely open up the economy in a safe manner. But to achieve this, mandatory testing of entire offices would have to occur on a daily basis, costing around $1.5 billion per week. That’s still cheaper than the weekly effect of the lockdowns on the U.S. economy.
Medical experts have seen some evidence of antibodies forming in the bodies of those who have tested positive for and then recovered from the coronavirus, but it is still unknown what level of antibodies is needed in order to be immune to the virus. It is also unknown how long immunity lasts.
Without any more scientific backing, antibody tests are no more than a placebo effect at this time.
Perceptions change as certain conditions become the new normal. Deaths per day may rise but then if that number stabilizes, will it feel to people that the situation is improving?
“If this is our new normal, I worry. What do we lose if we allow ourselves to become numb?” said Dr. Clayon Dalton, a resident physician at Massachusetts General and Brigham & Women’s Hospitals in Boston, in The New Yorker. “Over the Memorial Day weekend, more than three thousand new deaths due to Covid-19 were reported across the country, each one a mother, a husband, a brother, a neighbor, a deacon, a teacher – a whole galaxy of human life wrecked by a dangerous plague that’s on the loose and against which we have tools to use, if only our government would give them to us.
“To normalize this is to invite complacency, and complacency, as much as the virus itself, ought to be our enemy.”
A worldwide effort to combat the virus has led to about 150 vaccine candidates being scrutinized with pharmaceutical factories already being funded for the moment large-scale production of a legitimate vaccine can begin. A few of the coronavirus candidate vaccines are already going into production now, but it’s too early to tell how effective they’ll be.
The mumps vaccine currently holds the record for being developed and approved the quickest, at four years.