The medical and epidemiological community was taken off-guard by Covid-19. Now they’ve squeezed 10 years of research into one trying to save lives.
Faced with a voracious virus that sickens and kills more people every day, science detectives around the world and here in Columbus have had to push through uncharted territory to understand and contain the perpetrator, and they’ve needed help from the public.
“With the exception of HIV, we have never been in a situation where we’re flying the plane while we’re building it,” says COSI President and CEO Frederic Bertley, a specialist in immunology and vaccine development. Speaking of the work done on the life-changing coronavirus, he says, “It’s been detective work with ongoing pivoting and editing. We’ve been drinking out of a fire hose, continuously changing our understanding. We have been forced to figure this thing out right now.”
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In terms of scientific research and epidemiologic understanding, progress made in the last year is the equivalent of 10 years under normal circumstances, Bertley says.
Local experts say despite the warp speed progress, many questions remain and can be answered only by time and human behavior. They also understand the public’s frustration with guidelines and orders that have seemed to change day to day.
“We knew nothing about this virus” when it emerged early in 2020, says Dr. Joseph Gastaldo, system director of infectious diseases at OhioHealth. “I am very humbled by this whole experience.”
Through ongoing tracing, testing and observation, epidemiologists gleaned vital knowledge—that the virus’ primary mode of transmission is via droplets (sneezing, coughing, singing, speaking); that people should remain at least six feet apart from one another; and that masks are highly effective.
And they’ve seen that when large groups gather, more people are exposed to the virus. “The virus isn’t looking for people, people go to the virus,” Bertley says. “That’s why social distancing is so important, and masks provide a physical barrier if potential hosts get within arm’s reach of the virus.”
Epidemiologists know that someone infected with the virus can be contagious starting roughly two days prior to developing symptoms, and that about 20 percent of infected people remain asymptomatic, making them “silent spreaders,” says Maria Gallo, professor and interim chair of the Division of Epidemiology at Ohio State University College of Public Health. “Basically, we should assume that others are possibly infected and protect ourselves with steps that are known to reduce the risk of infection.”
Gastaldo says he worries about asymptomatic transmission, especially to those with risk factors such as age, obesity, diabetes, weakened immune systems and lung and breathing conditions. “That’s a huge part of our population at risk,” he says.
As the human toll mounts, scientists and medical professionals continue to search for answers to questions about key issues such as immunity. Once someone has had Covid-19 or received a vaccine, how long are they immune? The short answer: It’s too soon to tell.
“With chickenpox or measles, we have a lifetime of data showing that once you have it, you won’t get reinfected. We don’t have that for coronavirus,” Bertley says. Likewise, it’s unclear how long immunity lasts once someone is vaccinated. For example, scientists have to devise a new influenza vaccine every year because of its changeability.
New coronavirus variants already have emerged in countries around the world, including here. Gastaldo says at least one variant spreads more efficiently, which could mean additional infection and illness, such as happened in England, which shut down this winter.
He urges people to get vaccinated as soon as they are able, and until enough people are vaccinated, people need to stick with the measures that are proven effective, such as social distancing. “You can’t pick and choose mitigation strategies,” Gastaldo says. “They synergistically work together.”
Human behavior has posed a frustrating challenge for those battling the coronavirus. Radhika Iyer, infectious disease program epidemiologist and supervisor at the Franklin County Board of Health, says people have acted and reacted with disbelief at the possibility they could get or spread the virus. That became evident when activities opened up and the virus spread among sports teams, schools and social gatherings like showers and wedding receptions, she says.
The county department also has struggled with cooperation in trying to do contact tracing, Iyer says. In some cases, people have wanted details about a possible exposure that health care privacy laws prohibit epidemiology staff from sharing, or they argue that the contact never happened. Parents have sent videos to try to prove their children weren’t exposed at a sports practice, she adds. “We’ve had some very tough phone calls. People don’t want talk to us when we call. Our people have been trained not to take things personally, but we do encourage people to work with us.”
Bertley says the Covid-19 pandemic powerfully illustrates the theory of cognitive dissonance, the mental conflict that occurs when beliefs or assumptions are contradicted by new information. Human beings use various maneuvers to relieve that tension, such as rejecting, explaining away or avoiding that information. “There is an emotional component to this,” he says.
However, he says, “The virus is not a psychological entity. It’s not emotional, nor is it personal, racial or political. It wants one thing only—to find a host and replicate.”
Local experts say the pandemic has underscored the need for strong public health infrastructure at both national and local levels. Gallo says many local health departments don’t have enough resources to provide the necessary tracing to identify and quarantine their contacts. Conversely, the unprecedented speed of vaccine development would not have been possible without enough federal funding, she says.
Gastaldo hopes the Covid-19 experience will drive funding decisions going forward. “We are in a global world war, and we need to gather new science and technology and connect the dots in a much more efficient way. We need that infrastructure so that when there is another pandemic—and there will be another—we will be able to mount an attack.”
Laurie Allen is a freelance writer.