The main thing that will help Americans win their battle against COVID-19 and return to complete normalcy is a vaccine, the leader of North Georgia Health District said this week.
Speaking Thursday during County Connect, the Whitfield County Board of Commissioners’ twice-weekly show streamed live on the county’s website at www.whitfieldcountyga.com, Dr. Zachary Taylor listed three other smaller victories that would also help in the fight against the coronavirus – universal availability of rapid testing to determine if someone is infected, a test for antibodies to see if someone has been infected in the past, and an effective treatment to prevent victims from becoming severely ill.
Just when such a vaccine could become available remains to be seen, Dr. Taylor said.
“Vaccine development does take a long time,” he said. “One of the problems is they have to identify which part of the virus the vaccine needs to attack to be effective. Usually a vaccine prevents a virus from attaching to a cell or it may interrupt some other mechanism of the virus.”
He said how a vaccine can be designed depends on the particular virus and how quickly it mutates.
“The first thing they have to do is make sure it’s safe to give to humans,” Dr. Taylor said. “The second thing they have to do is make sure it’s effective when it’s given to humans. Then once they have decided this is the vaccine we’re going to use, it’s going to have to be mass-produced, and once it’s produced, then we have to get it out to the public.”
He says “we’re probably talking about next spring” before an effective vaccine is available. “It could be earlier – we’d all be happy if that were the case. It could be later depending on how difficult it is to find the appropriate candidate vaccine for manufacture.”
In the meantime, Dr. Taylor says the Whitfield County Health Department is hosting drive-through testing five days a week for people who believe they have COVID-19 symptoms, including fever, cough, and less commonly sore throat, nausea, and diarrhea.
“If someone believes they have those symptoms and they want to schedule a test,” Dr. Taylor said, “they should call 888-881-1474 to set up an appointment. We also have a testing site in Cherokee County, and we’re going to start one next week in Gilmer County.”
In Dalton, at 800 Professional Blvd., just past the Whitfield County Correctional Center, the health department is offering drive-through testing Monday through Thursday from 9 a.m.-3 p.m. and Friday from 9 a.m. to noon.
Dr. Taylor said 88 tests have been conducted this week in Whitfield County, with another 97 in Cherokee County. “We expect that number to pick up as people learn about the availability of our testing now,” he said. “We hope it does because we would like to test more people. We could probably do 300 or 400 tests a week here. And if we have a higher demand, we’ll expand our hours and we could do more testing.”
Hamilton Medical Center has also tested 224 additional patients, with 203 negative results, 13 positive for COVID-19, and eight results pending.
Asked about the CDC’s suggestion that a well-functioning monitoring system is needed before current restrictions are lifted, Dr. Taylor explained that rapid type testing needs to be widely available, and “we’re seeing improvements in that.”
“We were all frustrated early on about the availability of testing and the backlog that was occurring in our commercial laboratories to get the test results,” he said. “If we had a well-functioning testing system that was rapid where people could get their results quickly, we could quickly define people, diagnose people that were infected with this, we could isolate those people, and that would help us reduce the transfer in our community so that we could all function safely and have business as usually safely.”
Dr. Taylor said the lab being used by the health department has promised test results in 24 to 48 hours (much faster than the previous seven to 10 days early in the pandemic). “That’s a big improvement,” he said, “again, not where we want to be in the future, but it’s a big improvement over what we have had. So far they’ve been able to do that, so we’re hopeful that they’re going to continue to be able to do that. They are serving the entire state, so they’re getting a lot of tests in.”
As of Thursday morning, all those tests (the exact number wasn’t known by Dr. Taylor) have resulted in 34 positive cases in Whitfield County, with three deaths reported. Whitfield County Emergency Management Director Claude Craig said that statewide from Tuesday to Thursday, 876 additional positive tests were confirmed, with 182 more people hospitalized and 60 more deaths reported.
“I think it’s important for people to understand that there are many more cases that have occurred in our county and that are out there right now,” Dr. Taylor said. “Initially when there was less availability of testing, we would ask people who had mild illnesses to just stay isolated at home. We did not want them to overwhelm our health facilities, so many people didn’t get tested who had mild illness. We also know there’s a group of people who were actually asymptomatic and had infection. We think that group of people has been part of the spread of the virus in our community. That’s why you see people wearing masks in public, and why we think it’s important to wear masks.”
Dr. Taylor acknowledged that early on, health officials warned that masks weren’t effective. “There’s truth in that in the sense that a mask doesn’t necessarily keep you from becoming infected, especially the surgical-style masks that you see people wearing in public. They tend to have openings on the side so they’re not completely protective like the types of masks and respirators you see our health care providers wearing.”
But while it may not completely protect someone from the virus, the mask does keep a person from transmitting the virus to other people or to the surfaces when you’re out in public, Dr. Taylor said.
“So I would encourage you all to wear a mask if you go to the grocery store or if you’re out in public for some reason simply because you could have early infection, what we would call pre-symptomatic infection, or you could have an asymptomatic infection and so could therefore transmit the virus to other people you’re around,” he said, “and we’d like you to protect these people.”
Dr. Taylor also encouraged continuing to practice social distancing as much as possible and to be very conscientious about washing your hands. “If you’ve been out in public, wash your hands before you touch your face,” he said. “Make sure that you’re also cleaning surfaces, especially surfaces that are touched often, like door knobs, countertops, computer keyboards, your telephones, things like that.”
Asked about the use of plasma donations from patients who have recovered from COVID-19, Dr. Taylor explained giving such plasma to another patient transfers the first person’s antibodies so the second person can defeat the virus. “That’s certainly been used in other instances,” he said, “It was used early on when we were dealing with Ebola in some cases. It certainly is a plausible treatment. It’s undergoing clinical trials along with some other drugs that are anti-virals.”
As for the drug hydroxychloroquine (in combination with azithromycin, or Z-Pack) commonly used to treat malaria, Dr. Taylor said that combination is being tested to determine its effectiveness against COVID-19.
As for the so-called herd immunity, Dr. Taylor said we would need to get more than 80 percent of the population immune to the virus either from a vaccine or from previous infection. “But we don’t want to do previous infection because we know this particular virus, the illness it causes, it’s more severe than the influenza.”
While the current death rate is 3 or 4 percent, Dr. Taylor said the actual death rate will likely be much lower as more and more people are tested and the real distribution in our population is determined.
“The mortality rate is probably lower because of the cases we don’t know about,” he said, “but even if it’s 1 percent or a half percent, that’s still many fold higher than what we see with influenza. We’ve seen medical providers dying of coronavirus, and you don’t see that in a normal influenza season and people with influenza are hospitalized all the time. Of course, one major difference is we do have a vaccine for influenza, and we do have a treatment for influenza.”
Dr. Taylor stressed that the medical community still has much to learn about the coronavirus.
While someone who has recovered from the virus may have immunity to it, he warns that how long that immunity is remains to be seen.
“It’s possible that you initially would be immune to reinfection,” he said, “but that immunity may wane over time, so you could be reinfected.”
Likewise, that might be true for people who receive an eventual vaccination, he said, “so there might have to be some type of intervals of vaccination – annual, two years, five years. We’ll see as we learn more about the virus and what we need to control it. I don’t know the exact answer, but you’re probably going to have to take the vaccination more than once in your life – but the frequency I don’t know.”
While having mumps and measles gave people his age lifelong immunity, Dr. Taylor said “we don’t necessarily expect to see that with COVID-19.”
He explained that scientists have known about coronaviruses for about 40 or 50 years and probably have existed for centuries. “We do know they’ve been around a long time, and we do know also they exist in humans and animals,” he said.
He pointed out in the past 20 or so years, the SARS coronavirus was worse than COVID-19, but it wasn’t very infectious and “sort of went away” on its own. Another type known as MERS (Middle East Respiratory Syndrome) goes from camels to humans and is primarily restricted to the Middle East.”
He said the latest coronavirus, COVID-19, is a very infectious virus and is easily transmitted from human to human.
Asked by a viewer if the health department had a need for donation of supplies, Dr. Taylor said “not at this time, but that is very nice of them to ask.”
He praised the staff at the health department, saying they are doing tasks they don’t normally do, especially the COVID-19 testing. “They have to do the drive-through testing, so they’re out there whether it’s raining or cold or hot or stormy. They’ve really stepped up to provide this service to the community, and I’m proud of what they’re doing and I hope the people of this county are proud of what they’re doing.”
Dealing with COVID-19 has “really been tough, I know, for everyone,” Dr. Taylor said.
“I hope we keep compassion in our hearts, both for those who are ill, those who are hospitalized, and that we help each other, especially our population that has chronic illness who are at greater risk. There are a lot of things we can do for them. We can shop for them so they don’t have to go out in public. We can stay in touch with them so they don’t lose touch; they’re isolated and not able to get out. They need people to call and talk to them.”
He also urged compassion for political leaders. “This is a really tough time,” he said. “I don’t envy the governor at all having to make these decisions, and I don’t envy any of our political leadership for having to make these decisions they’re making because they’re not easy decisions to make.”
All in all, he says, there are no really good answers. “People are suffering economically from the stay-at-home order,” he said, “but if you release that too early, people are going to suffer from getting sick and our health care facilities could be overrun. So let’s all have a little compassion in our heart for each other.”