COVID-19 Editorial: Important COVID-19 Issues That Need To Be Addressed To Move Past The Pandemic

COVID-19 Editorial: Its Sunday 24^th Of May and the official global death toll is now 343 852 while 5.4 million people are officially infected. (America’s death toll is 98,692 conservatively, in reality the number could be as high as 135,000 as deaths in nursing homes, and many deaths where individuals were not tested were not included to deliberately keep the figures low.) There is very little to be optimistic about the COVID-19 pandemic despite the recent “drop” in cases in countries and the lifting of shut down measures in various locations. If there is any cause for optimism over the response to COVID-19, it is this: Every day, we are learning a little bit more about this new coronavirus. It is actually quite remarkable if one was to think about where we were in February, compared to where we are now.


 
Currently, we are rolling out new diagnostic tests, exploring and developing new treatment options, and we even have an accelerated vaccine timeline. 
 
Unfortunately, we are by no means on the other side of this pandemic. To get there, we’re going to need to come up with answers to these critical issues.
 
Is The SARS-CoV-2 Evolving And Mutating And Becoming More Potent And Aggressive?
 
Despite so much advances in the field of genomics and despite thousands of genomic sequencing done so far, the key question is has the SARS-CoV-2 coronavirus mutated and become more adaptable, resistant and aggressive? It is strange that there has been so little on this and while some ‘experts’ are claiming that the virus has not mutated or that even if it mutates it is most likely to become weaker. Certain pre-print studies that have yet to have been peer reviewed are suggesting just the opposite and also clinical manifestations and even newer reports on longer incubation periods are all pointing to a more alarming direction.
 
True Mortality Rate
 
The current mortality rates are accurate only to a degree. It is a simple matter of data set size. The more tests we have, the more data we have, and the more accurate our projections about the infection and mortality rates become. Without knowing the actual mortality rate, how do we know if we’re overreacting, under-reacting, or getting the social distancing/shutdown response just right?
 
The only solution to address this question is to expand testing,a refrain that we have heard from researchers since day 1 of the epidemic. We are making progress on that end. Rutgers University recently rolled out a saliva-based, rapid antigen detection test. But until we have something instant like something akin to a pregnancy test that can we safely allow people to return to work.
 
Also let’s say we know the actual death rate. This raises the ethical question of, how many deaths are acceptable? 
 
Risk To Children
 
In the beginning of the pandemic, many believed that children would largely be unscathed by COVID-19. And statistically, that does appear to be the case.
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However, the recent emergence of about 150 cases that look similar to Kawasaki disease, mostly clustered in New York, are cause for concern. Are these isolated incidences, or the early onset of a trend for the virus?
 
Again, knowing the answer to this question is critical for the reopening of America and other countries. Harried parents across the U.S. want their kids back in school so they can get some relief and get back to work, but is it safe for them to return? And what precautions might we have to take prior to widespread availability of a safe, effective vaccine?
 
Safety Of Accelerated Vaccine Timetables
 
Talking of vaccines, we are heading into uncharted territory. President Trump’s Operation Warp Speed calls for 300 million vaccinations by January 1, 2021. For context, the record for bringing a vaccine to market is 4 years, held by the mumps shot. To hit that January 1 mark, we’re going to have to jump directly into human trials.
 
Now comes the ethical questions, as well as technical ones. For one, is it right to inject millions of people with a vaccine that hasn’t been subjected to the usual rigorous FDA trial process? And more importantly, how will we be sure that it works and that there aren’t any adverse events without the usual trial phases? 
 
Seems there’s a tradeoff to be made here: Save lives by bringing a vaccine to market quickly, or be methodical to minimize risk? Once again, knowing the actual death rate would make answering this question a bit easier.
 
No Drugs That Actually Work So Far Against COVID-19 And The BS About Remdesivir
 
To date we have only one ‘effective’ COVID-19 drug.But just how effective is it? Unfortunately, as reported by STAT earlier this month, the jury’s out. NIH researchers elected to give patients earmarked for placebo the drug before the study was complete. The thinking was that from an ethical standpoint, carrying the study through to its designated length put more patients at risk of dying when early results seemed to indicate that remdesivir could help.
 
At the end of the trial, STAT notes, among those who received remdesivir, 8% died. Gilead and the US Government is putting extensive PR efforts to make remdesivir look like a ‘cure’ when it is not. Why?
 
The Extent Of The Mental Health Toll?
 
How prepared are we for the mental health pandemic that’s likely to be on the heels of the COVID-19 pandemic? For months, individuals have been living in isolation, separated from their support networks of friends and families. Elements of everyday life such as going for a walk or shopping for food  have become anxiety-provoking brushes with illness or death.
 
Nearly 341,000 are dead, and their friends and family have not had the chance to even properly grieve the loss of the people they love. Unlike cases of the virus, it isn’t as easy to measure the mental health impact. We’ll likely only gain a sense of the scope in the years to come. 
 
Welfare Of Doctors  And Other Healthcare Workers
 
Prior to COVID-19, Burnout was a problem. Now, many doctors have been working non-stop to keep patients alive. Others are watching their practices shrivel as elective procedures have been put on hold, and patients avoid seeking care out of fear of falling ill with the virus.
 
There’s been much focus on financial support for Americans at large, but little discussion about supporting American physicians and healthcare workers. We need to understand what their fiscal and emotional needs are to keep continuing their critical work.
 
Are There Residual Amounts Of The Virus In So called Recovered Patients And What Is The Effects On Their Long Term Health
 
Another interesting question that has yet to have been addressed properly. The PCR NAT tests are not sensitive and accurate enough to pick up less than 85 copies per ml of the virus according to certain manufacturers. So does the virus exists in recovered individuals or not?
 
And if they do, what is the effect on their overall health. Does the virus remain dormant? What reactivates it? How does it affect the health of the individuals? Will we see more new chronic health issues?
 
This is the most important issue as we have officially about 5.4 million people who have been infected while there could be millions more of asymptomatic people out there.
 
Will medical textbooks and guidelines have to be rewritten in the next few years?
 
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