Coronavirus Q&A with Dr. Stephen Prescott: July 24 Update

Posted on 07/24/20

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Dr. Stephen Prescott, Oklahoma Medical Research Foundation president, answers your medical questions about coronavirus and Covid-19.

Is Covid-19 fatigue a real thing?

Yes, absolutely. And you can look at “Covid-19 fatigue” in two ways, both of which are real. First, a number of people experience intense fatigue that comes with Sars-Cov-2 infection, and it can persist for weeks after recovery from the virus. Like everything with this virus, it varies in severity on a person-to-person basis. Some people bounce right back, but some of the worst cases of fatigue reported include individuals struggling for a month or longer with intense bouts of fatigue, diminished concentration and muscle aches. This needs to be researched further, but it’s one more reason to be cautious and to protect yourself.

This leads directly into the other type of fatigue. As cases in Oklahoma continue to surge, people are tired of hearing about anything Covid-19: masks, guidelines, restrictions, quarantining and everything else they’ve heard since March. They want to return to normal life. But the more people refuse to act like Covid-19 is here, the longer it will persist.

I wear a mask when I’m out. Should I also be wearing gloves to places like the grocery store?

This is a personal preference. It’s certainly not a bad idea, as it offers an added layer of protection, but it’s probably not necessary. We know for certain that the primary method of virus transmission is through the air, not off surfaces. And we know you cannot absorb Covid-19 through your skin. Wearing a mask is still the most important thing you can do if you have to be in public, and be vigilant about washing your hands. Gloves or no gloves, don’t touch your face before you have thoroughly sanitized. Don’t let the gloves give you a false sense of security.

How often to do I need to wipe down and clean surfaces in my house and car?

This is a tricky one because it’s completely situational. A good rule of thumb would be: if you’ve been out, take precautions and disinfect. Steering wheel, door handles, shared surfaces, and don’t forget about things like cell phones, headphones, wallets and purses. But if you’ve been good about social distancing, there’s no reason to go outside the ordinary cleaning routine.

Are new symptoms of COVID-19 emerging as time goes on? If so, are you seeing a trend of different symptoms emerging in varying age groups?

I’m going to address the second part first. I don’t know exactly about symptoms being different in age groups, but you can expect that would be true. Practically everything else has differential expression based on age. Kids tend to have more subtle symptoms, while the elderly can get a lot sicker. To my knowledge, this has not been systematically studied in the context of Covid-19, but at some point, I would expect to see a spectrum that reflects age. As for the first question, I don’t think we have seen new symptoms develop, but what is becoming apparent is the less-common symptoms that initially didn’t concern us. The obvious ones were cough, fever, shortness of breath and other flu-like symptoms. Now we are seeing nausea, vomiting, diarrhea, confusion, intense fatigue and others. But this is the typical progression when we see a new disease or virus: the most common symptoms aren’t the only symptoms. It takes time for physicians and scientists to recognize them all.

If I am not showing signs or knowingly been exposed to Covid-19, should I still seek out medical testing?

Not necessarily, unless you have a specific reason. If you’re young and going to visit a grandparent you haven’t seen since the pandemic started, then yes, it would be a good idea. Or if you are a grandparent and people are starting to feel brave enough to come visit, I would insist they get tested before doing so. But routinely testing just to test, I’d say no. For example, a friend of mine has a mother with a severe underlying condition, and the son has not had any symptoms or tested positive, so, strictly speaking, he doesn’t need to get tested. But if he wants to visit his mom, that is a sensible, thoughtful preventative measure worth taking. For a lot of us out there: No symptoms? No exposure? No reason.

Should I consider an anti-body test?

In due time, yes. An antibody test will tell you if you have had the coronavirus and if your body made an immune response to it. It will not tell you if you currently have it; this is not the test to get for diagnosis.

With an antibody test, if you’ve had Covid-19, you should get tested several weeks later, because that’s when we’ll see optimal response from antibodies. Unfortunately, we still don’t know if antibodies provide protection from this novel coronavirus. Odds are that they will, but there are counterexamples where a second infection can be far worse, and it is the antibodies that help make it worse. This is a phenomenon called antibody-dependent enhancement, and OMRF actually just received a $1.75 million grant to help determine whether or not this happens in the context of Covid-19. But, because this virus is so new, we still don’t know where natural immunity will land. We certainly hope it will be protective, which is likely, but it’s not a certainty.

The good news is, one way or the other, we will know this answer soon, but we need people who have recovered—or even those who think they may have had it—to get antibody tests a few weeks after they’ve recovered. These answers are going to have major implications for vaccines.

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AARP and the coronavirus

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