Dr. Rai talks testing struggles, vaccine trial and COVID’S long-term effects
Dr. Rai joined us on Action 2 News This Morning Tuesday to talk about testing, the new vaccine trial, and masking in schools.
GREEN BAY, Wis. (WBAY) - One of the biggest obstacles in fighting the coronavirus is testing.
”Some weeks we get what we need, and some weeks we have to ration back and not test as many people. And that’s somewhat counterproductive. If you remember, we’re trying to measure that percent positivity and trying to get that number to go down,” says Prevea Health President and CEO Dr. Ashok Rai.
Dr. Rai joined us on Action 2 News This Morning Tuesday to talk about testing, the new vaccine trial, and masking in schools. Watch the videos in the story for answers to your questions.
Dr. Rai joins us on Action 2 News This Morning each week Tuesday and Thursday. Have a question? Email firstname.lastname@example.org.
Thirty-thousand people are part of a trial for a potential break-through coronavirus vaccine developed by the National Institutes of Health and Moderna Inc.
“What they found out in phase two were the side effects were extremely minimal, very localized in a way. In other words, some pain at the injection sight. Might have felt a little malaise or tiredness for 24 hours and then got better. They assessed safety in phase two that they feel that they can go into phase three safety. In phase three, they’ll continue to assess safety. You don’t just stop. About half the people in the trial will get the vaccine, half aren’t. There’s going to be a lot of blood drawing in that time period because they’re going to want to see the types of antibodies that people produce with the fake vaccine, essentially water, and with the real vaccine. And are those antibodies being produced against COVID-19 and are they the kind of antibodies that actually neutralize the virus. And what dose. They kind of determined that in phase two. It takes two doses to get effectiveness. So they’ll use that in phase three. So phase three is really important because you’re looking at two major outcomes expanded on phase two. Safety being one of the biggest ones, and effectiveness being another. The thing we won’t know for some time is how long the vaccine will last for. Is it a six month-one year type of situation? Or is it lifelong? That, once again, is going to be one of those rear-view mirror type of questions.”
“So the state will advertise 24,000 tests could be run on a day, but every single lab is fighting for the same materials--the re-agents, the necessary pipette tips that go into the machines. All the different things that are involved in the supply chain. And then the labor and getting the tests to Madison to run them, or whatever city they’re being run in. All of those steps since March have not been perfected by any means. For example, at Prevea, every week we don’t know what our allotment is going to be from the state to do the community testing we’ve been doing. Some weeks we get what we need, and some weeks we have to ration back and not test as many people. And that’s somewhat counterproductive if you remember, we’re trying to measure that percent positivity and trying to get that number to go down. And for that to happen, you have to adequately test your community. So it’s a big struggle. Right now, I’d say the ideal timeline would be 24-to-72 hours. Anything past that, probably not as acceptable and starts to get into the situation where people are not isolating after their test and it’s very frustrating.”
SCHOOLS AND FACE MASKS
“I think probably the best thing on the face covering is something that, once again, covers the nose and covers the chin. And make sure if kids are wearing glasses that we’ve got something to maybe crimp down around the nose like I do with my mask to prevent the air from fogging up my glasses as much. And there’s a couple other tricks in there. But really, a face shield is not good enough. You want something that covers the chin and the nose completely for it to be effective.
I think [mask] breaks are a great idea. Let’s just make sure the breaks make sense. In other words, make sure the kids can be far apart during that time period, not exposing each other. Outside would be ideal. Recess would be ideal to get people spread out, outdoors, using Mother Nature’s HVAC system to get air exchange going. But if you’re going to take the masks off indoors, make sure the kids are separated far enough.”
“If you’ve had a significant exposure--defined by the CDC as within six feet for 15 minutes talking to somebody, hugging or kissing somebody, sharing food utensils, very close contact--being tested is not always recommended. The quarantine is what’s important. The 14 days since that exposure. But really, if you need to be tested, the point of being tested is number one, you have symptoms and we need to monitor you. Or number two, you may have exposed other people. So the ideal time they say is anywhere from two-to-14 days to get tested. That 14 days is the incubation, and a couple days for the virus to actually infect you. But understand, even a negative test during that time period still means you need to quarantine.”
SURGERY AND ER SAFETY
“We’re doing a lot of things in the hospital to make sure it’s safe. It’s probably the safest its ever been if you look at our cleaning policies, our masking policies. The chance of you coming into contact in the hospital is a lot less than it is out in public right now. It’s very safe to get elective procedures done. And if you need help. So a lot of people, for example, are avoiding emergency rooms if they’re having symptoms of a stroke or a heart attack. Don’t do that. It’s a safe place to go. Same thing for elective surgeries. People are being tested, people are being screened when they come through the door. We’ve limited our visitors. We’ve limited the contact so you can have a really successful and healthy surgery.
LONG TERM RESULTS
“It’s really hard to define that right now because it’s really a rear-view mirror question, so we don’t know a year out. But I can tell you as it stands today, as we look at patients that say left the hospital in April and May, they are still struggling with respiratory problems or need for physical therapy due to muscle weakness. Some were put on dialysis. They’ve now come off of that, but still need long-term kidney monitoring. Some need heart monitoring. So there’s a lot of long-term follow up that we’re seeing today. Are they going to full recover at some point? We don’t know. I think that’s a really important question because so many people are focused on the mortality, how many people are dying. But the long-term morbidity of all of these long-term consequences of surviving COVID is something we should also talk about. Because it’s definitely at tax on patients and on the health care system. People really are sick even after they leave the hospital.”
“I’d say the 14-day trend has been flat. We’ve had some peaks and some valleys in that time period. We’d like to see it move down. It’s not in that 10 percentile range. We got in the fives and the sixes for awhile. Back up to nine and eight. Remember not to follow this day-by-day. Look at it a seven and a 14-day trend. Right now it’s about flat. We want that to angle down significantly, and angle down so it’s persistently below five percent. Ideally below three percent. But five percent would be that ideal target for the state and the localities to look at.”
WIAC and Midwest Conferences have canceled fall sports.
“I commend the colleges that have made that tough decision, the divisions that have had to. If you think about what they’re looking at, they’re looking at how to get young athletes back to school and educated. That’s their priority. They’re also looking at what resources are available to keep the athletes safe on the field. We talked about testing resources earlier in the day. Those are stretched right now and they’re needed in other places. Think about personal protective equipment. Let’s think about football for example. The training rooms, the sidelines. How much PPE will we burn through on the sideline which could be used in the office or the hospital?
The WIAA obviously made a different decision using different factors than that. But really, from a health care perspective and a societal perspective, our focus is on educating the students and making sure that’s safe, and not having other situations being created that could increase the spread of the virus, such as a contact sport such as football.”
IDEAL CONDITIONS FOR BACK TO SCHOOL
“I wish we had that scientifically proven: this is the exact number to aim for. If you look at the World Health Organization, the Johns Hopkins coronavirus website, they really look at less than five percent positivity to define outbreak versus non-outbreak. If you look at the school strategies, they’re designed to mitigate an outbreak--in other words try to prevent one. So from a common sense standpoint, if we can aim for below five percent and stay there, then the things that all the superintendents, the school nurses, the teachers, the janitors are all working towards may have a chance to keep kids in school for a longer period of time. If that number’s above five percent, a lot of those things to mitigate are not going to work as well if not work at all because the virus is so rampant. So our goal right now should be how do we test enough people? How do we isolate enough people, mask enough people, to get that percent positivity below five percent and keep it there so we know kids are going to be safe in school. And remember it’s not just kids in school. It’s adults in school that need to be able to teach them.”
The Miami Marlins have had to postpone games due to a coronavirus outbreak among the team.
“It’s concerning. Obviously they’re in a congregant setting. All it takes is one person to infect 14 people very quickly. We’re going to have to watch this. It’s a very protected environment and we saw how quickly it spread. Now think about the non-protective environments, such as say a high school team and how quickly that can spread and spill over into the classroom. That’s probably the biggest concern that we’re watching right now.”
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