What We Misunderstood about COVID-19
This is part of our “In Medical News” series where Dr. Sara Laudani shares a study or article in recent news and offers some analysis and tips about the news, to help patients stay informed.
Medscape published an article in March on the one-year anniversary of the World Health Organization declaring COVID-19 a pandemic. It looks at some of the many ways the virus was underestimated or misunderstood and what that cost us. Here’s an overview of those and what we’ve learned so far.
Treating COVID-19 Like the Flu
March 2020: No need to panic. The flu is worse.
March 2021: It's worse than the flu.
In March 2020, the US had a plan for responding to a pandemic, but it was built around the flu. Few people in public health suspected a coronavirus could be this much of a threat for this long. Though there was good historical precedent for thinking that way, this virus turned out to be “novel” in all the worst ways. It has the characteristic that often causes flus to become pandemics, with people shedding the virus before showing symptoms (whereas other coronaviruses, like SARS and MERS, have mostly been contagious simultaneously with symptoms). Yet, it has obviously had many of its own characteristics in terms of contagion and effects.
The Necessity of Mask(s)
March 2020: Masks aren't necessary.
March 2021: Consider wearing two.
Though there was good evidence to support the use of masks early on (and most Asian countries were using them), messaging about masks got muddled. Experts wanted to quell the supply shortage for healthcare workers, but this ended up confusing people. This new virus meant that the public was watching the scientific process in action, which is one of testing and learning. We now understand that proper masking is a vital measure given the airborne nature of COVID-19.
Assuming the Virus Doesn’t Stay in the Air Long
March 2020: We don’t think the virus stays in the air long.
March 2021: Check your CO2 levels and ventilate because this virus definitely hangs around in the air.
In March 2020, the WHO cautioned that there was no evidence that the virus was lingering in air and making people sick. Meanwhile, experiments were showing conflicting evidence and scientists finally forced the issue with the WHO in July. As a result, they revised their guidance and talked about the dangers of airborne transmission. However, scientists still say not enough is being done to address this method of transmission.
Focusing too Much on Symptoms
March 2020: Asymptomatic spread is rare.
March 2021: 40% of new cases come from people without symptoms.
As mentioned above, other coronaviruses have been manageable because monitoring symptoms could contain them. We now know it is likely 40-45% of COVID infections come from asymptomatic people. So, focusing solely on interventions like health surveys and temperature checks isn’t effective.
For this reason, the US didn’t realize in early March that the catastrophe unfolding in Europe was already doing the same there. Scientists later estimated the 500 cases and 19 deaths across 34 states that were known to the CDC at the time of the pandemic declaration were only a fraction of the actual number in the US.
“The real tragedy was not having any COVID-19 testing for the first 2 months of the US pandemic, which promoted diffuse spread of the virus across the country, and we've never been able to contain it since," said Eric Topol, MD, professor of molecular medicine at Scripps Research.
Thinking the Virus Doesn’t Affect Young People
March 2020: We don’t think the virus is a threat to young people.
March 2021: Sadly, no.
Many continue to believe this message. Meanwhile, in summer of 2020, adults under 30 accounted for more than 20% of all COVID cases in the US. And sadly, more than 12,000 Americans under the age of 45 have now died from COVID-19.
What does all this mean today?
The good news is the rapid progress of the science on this virus. We have learned a lot and there is solid data to support the containment measures that work. And the process of vaccine development and roll out has been an unprecedented effort.
However, as one of the scientists shared at the time: "I think it's important to remember, even though it seems like forever for all of us, we're only a year into this outbreak. And so, it's going to take us a while to sort through the mechanisms and what's unique about this virus."…"It has lots of secrets we haven't worked out yet."
The unfortunate missteps during this pandemic have been devastating. Hopefully, though, what we have learned will continue to help us with this virus and potential future viruses. As experts share, with new variants emerging we must remain humble and open to learning and changing to safely deal with what might come next.
Dr. Sara Laudani offers consultations in internal medicine and functional and nutritional medicine in our Hongmei Road Clinic – Hongqiao. Click here to schedule an appointment with her and find out how her holistic approach and protocols can help you resolve your health issues.