Doctor of Medical Sciences and infection disease specialist Walter Owens answered all our questions about coronavirus (COVID-19), its treatment, dangers, and prognosis.
The news reported that children are almost not affected by coronavirus, while elderly people with chronic diseases die from it. Why does it happen?
Conclusion can be made only after this virus is finally studied. But viruses, in fact, adapt in different ways to different cell structures in the human body. Coronavirus is associated with two main localizations – the respiratory tract and intestines. The structure of the cell where the virus enters is important for the development of the disease: the virus is the same but the conditions for its reproduction in the cell are different. There is a difference between the structure of the tissues in a child and an adult, therefore, most likely, the conditions in the cell of an adult are more suitable for this virus.
If we talk about the fact that older people with chronic diseases die most often from COVID-19, then we can draw a parallel with the same flu. During the flu, people over 60 face more severious complications, and their chronic diseases make it worse: diabetes, cardiovascular chronic diseases, long smoking history, hypertension, and chronic obstructive lung disease and chronic renal failure.
Is it true that 2 out of 100 patients with coronavirus can die?
The statistics will change over time because there are still many questions related to the fact that not all patients go to the doctor. And the statistics include only those who just asks for help, and, according to it, 2–2.8% of 100 COVID-19 patients will die. Yes, these statistics are not as significant as with many other diseases, but these figures should also not be underestimated.
On the other hand, we see that human immunity quite often copes with a viral infection: 98% of those who have encountered a coronavirus recover.
How is coronavirus currently treated?
I will mention several drugs that are now used in the treatment of coronavirus in various combinations. First of all, it is Ribavirin. This is a drug that was previously used together with interferon for the treatment of hepatitis C. And now, Ribavirin is also used in the treatment of with some forms of hepatitis. It is a well known antiviral drug.
Doctors also use Lopinavir/ritonavir. This medicine is still used to treat HIV infection. In addition, interferons are included in the therapy: alpha-interferon is used for inhalation, and beta-interferon is usually used for multiple sclerosis. This is a rather expensive drug.
Also, according to the latest data, Chloroquine (also known as Aralen) can be effective in the treatment of coronavirus. This is an anti-malarial drug. Besides, it can help reduce SARS-CoV infection and spread. This drug was invented in 1944. Researchers in China found that treating patients with coronovirus-associated pneumonia with Aralen may shorten their hospital stay and improve their outcome. Chloroquine (Aralen) is also mentioned in a guide to the vaccines and drugs that could fight coronavirus published by Vox Media.
The serum of patients with coronavirus is also important: it is transfused to the infectedpatients, but this is done only with systemic lesions. Nonspecific immunity is enhanced with drugs containing immunoglobulin.
However, while there is no consensus and some research results, which is most effective in the treatment of coronavirus. Some patients with coronavirus in China received Oseltamivir as a starting therapy. Doctors use other treatment regimens now because this drug is only used for the flu.
And if a person has coronavirus fever, doctors will fight it?
Yes, of course! Patients who have severe conditions always receive replacement therapy: if there is a problem with the kidneys, then this is extracorporeal detoxification, with respiratory failure – it is respiratory support, the help of ventilators. In ordinary cases, this is a decrease in heat and detoxification of the body. To create passive immunity, we also introduce immunoglobulins to such patients. This is a whole complex of measures that depends on the case and its complexity.
A coronavirus patient will be taken to an infectious diseases hospital immediately but what will happen next?
The patient is isolated in a boxed unit. If this is a patient in a severe condition, then he or she will get in boxed resuscitation. Depending on the situation, the building will be closed, but if there are many such patients, then clinics may also be closed. The box has a separate entrance and exit for the patient and also a separate entrance and exit for the medical staff. The same system exists in boxed resuscitation.
Doctors will come to such a patient only in protective clothing, the same thing is happening now with every suspicious case.
In what percentage of cases can ventilators be needed?
This percentage is small. About 15% of 100 patients with coronavirus have a serious condition, while several people may need mechanical ventilation.
Is there a reserve of drugs for coronavirus?
A reserve of drugs is always created. Now the reserve consists of antiviral drugs, there are solutions for the removal of intoxication, there are antibacterial drugs. From the experience of China, it is obvious that the most difficult cases are accompanied by the bacterial flora and doctors presribe antibiotics. Moreover, there is a supply of drugs in almost every city.
The WHO reports that the first human trials of the coronavirus vaccine will begin in four to five months, and they can use it in six months or a year. Why do you have to wait so long?
Any vaccine must go through entire stages of testing because there is nothing worse than ill-conceived decisions. If it is effective and there is no side effects, then first the vaccine will be given to those who need it urgently, and after the fourth phase of the test it will go on sale.
In my opinion, this vaccine is quite likely to appear within the time frame announced by the WHO.
The coronaviruses that people become infected with have been known for a long time, but why are there still no vaccines?
Coronavirus infection (I’m not talking about the one in China but in general) is an infection that causes symptoms similar to SARS. And this disease occupies about 15% of the total number of SARS. The question of vaccination should always be justified: why are we doing this? Diphtheria is a deadly disease, and we get vaccinated, tetanus is a deadly disease, flu is a serious disease with serious complications, coronavirus infection was not perceived like that. Three of its species were perceived as the cause of acute respiratory viral infections in humans, one as a diarrheal infection with intestinal damage, but then the Sars virus appeared, then Mers, and now COVID-19. Now there are more than 30 known viruses and 8 of them cause human disease. And the new vaccine will be the first vaccine for coronavirus.
Let’s talk about medical masks. Still, do we need them or not?
The WHO recommended that a sick person should wear a mask so as not to spread the disease. But if you walk alone in a mask on the street, and it’s freezing on the street, you need to think: what are you doing and why? Who are you trying to protect yourself from?
If you get sick and wear a mask, then you need to change it periodically. It is also important to pay attention to hand washing – after all, the virus is transmitted by contact and now there is research that it can live on the surface of objects for quite some time.
If a person flies through a major airport, but he or she is healthy – is there a necessity to wear a mask?
There are large crowds at airports, and if a person is not comfortable, then a mask can be worn. Much more depends on the emotional state. If someone near you coughs and you spend several hours with this person, then you can also use the mask.
On the other hand, you need to understand that we do not have such crowded people as in Asian countries. The mask has already become part of the local culture in China, and the locals wear them all the time.
And what about you? Are you afraid of coronavirus?
Well, infections are our dangerous neighbors, but, on the other hand, we cannot live without microbes and our life directly depends on microorganisms. During the rise in morbidity, fatal cases cause alertness in any person, any doctor and infectious disease specialist, but this should be treated with caution. Medical workers are at risk, they must take all measures to protect themselves against infections. They need to be wary, but in every situation you need to be professional and calm.