Your Covid Questions

First, a little perspective. Just last week we watched as two tropical storms made their way through the Gulf, headed toward Texas, Louisiana, and other states. That hasn’t happened in recent history and was frightening. One would become a category 4 hurricane and cause major damage to part of our country. This fall, we’re going to face another two storms, this time threatening all of our country. Covid-19 will still be here, as well as whatever variety of the flu that makes its way to our shores.

Now for the good news. I want to sincerely thank the readers of my columns for taking the time to submit your questions regarding our current pandemic. I won’t be able to handle them all here, but I intend to address each one over the next week or so. Please keep them coming! But before we start, here’s an update on the issue of anti-hypertensive medications and their impact on a coronavirus infection. This had to do with the ACE inhibitors (Lisinopril, Benazepril) and the ARBS (losartan and others). The first word we got was that they increased the chances of contracting Covid-19 and having a much worse outcome. That scared everybody, including physicians. Then we learned that the drugs don’t have a negative impact regarding Covid-19. They don’t increase your risk of getting the infection, and they don’t cause a bad outcome. Hot off the presses is a study of 28,000 people that indicates that these drugs reduce bad outcomes in those taking them by as much as 33%. This is important for those of us who take these medications, as well as for all of us as we try to assimilate information and research that comes at us daily. There are many questions to be answered about this virus, and as always, time seems to be the arbiter of truth. Now for those questions.

Do you think it’s pronounced COvid like “covert” or CUvid like “covers”? Personally I think it’s the second due to lack of an E to make it a hard O, but my kids keep telling me that I’m wrong. Please help.

I thought I’d be brave and tackle the toughest question first. I’m afraid your kids are correct. It’s pronounced COvid—just like cosign, command, cozy. No help from Webster, so I’m sticking with that.

Just how accurate are the test results? Positive one day, negative two days later, then back to positive.

First, we need to consider the two “diagnostic” tests. These are your rapid antigen tests and the PCR “send-out” study. The rapid test has an accuracy of around 80%, with few false positives and up to 20% false negatives. If it’s positive, you’ve got the virus. If the test is negative, there’s still a 20% chance that you could be infected. This is a nasal swab, and should probably be a little uncomfortable if an adequate sample is to be obtained. (Saliva tests are in the works and may soon replace the swab.) The results should be back in about half an hour. The PCR (send out) is much more accurate and should be done if the rapid is negative and the circumstances require absolutely knowing the possibility of infection. It may take up to five days to be returned. With either of these tests, the time from exposure to testing is important, and current guidelines indicate eight days to be the best interval.

Antibody tests check for the presence of just that—antibodies to the coronavirus. It won’t tell you whether you have an active infection or whether you’re immune to the Covid-19 virus. There are other coronaviruses out there, and this test can produce more questions than answers. It’s place in our fight against this virus has yet to be determined.

Is the flu vaccine going to incorporate Covid-19 vaccine without our knowledge? Not sure I’m getting the flu vaccine. Don’t know who to trust.

You can trust your mother. Short of that, I share your concern about a lot of what’s out there regarding the coronavirus. But I’m not concerned about this frightening prospect of Big Brother slipping us the Covid-19 vaccine unawares. That won’t happen. But having said that, it’s important to get the flu vaccine each year. This year may be especially important (remember those two storms inevitably converging). And this is a good time to remind each of us over the age of 60 to be sure we’re up to date with our pneumonia vaccinations. This infection is preventable and is a real killer.

And lastly, are doctors in South Carolina, specifically Rock Hill, treating Covid-19 patients with hydroxychloroquine and if not why?

Interesting. The question implies that if the drug is not being used, it should be. The reality at this point is that there is no substantial evidence that it makes any difference in the treatment of this infection. There are no studies that support its use. Lots of anecdotal reports, but nothing that can be substantiated. Regarding its use here in Rock Hill, I don’t know of anyone who is using this medication. If they are, and they have evidence to support it, I’d like to see what they’ve got.

That’s it for now. I’ve got more questions to answer and will start working on them!