With the first semester now in the books and students back on campus for their second, the university is looking back at how it handled COVID-19, and the results suggest their method could become a nationwide model as we continue to work to come out of the pandemic.

The university said their positivity rate plunged below 1%, and they had no major outbreaks, hospitalizations or deaths. School officials expect similar results this semester, and their personal testing protocol is at the heart of this belief.

Illinois’ Testing System

After the campus closed last March, chemistry professor Paul Hergenrother began brainstorming COVID-19 testing solutions. He realized that everyone on campus would need to be tested repeatedly to really help reduce asymptomatic transmission, and he also understood that mass nasal swab testing would be costly and difficult to pull off regularly. Instead, he and his team quickly began looking into saliva-based testing.

In what they called a six-week “blitz” period, the team attempted to develop a quick, efficient and inexpensive COVID-19 test. Thousands of different attempts failed before they found a solution that involved heating a saliva sample to 95 degrees for 30 minutes to kill the virus before it could be safely handled by health workers to be analyzed to see if the virus was present.

An on-campus veterinary lab was converted into a testing facility, but researchers understood that mass testing was only part of the equation. They also needed to have quick turn-around times so that students weren’t unknowingly spreading the virus while waiting on test results. That led to the development of twice-weekly mandatory surveillance testing on campus that provided for test results within 12 hours. But again, quick test results were only part of an effective solution.

Next, researchers needed to develop a way manage students who tested positive. The university saw a large surge in infections after the first week of classes, mainly because students who had the virus were not effectively self-isolating. On Sept. 2, the university urged students to stay home for two weeks except for essential activities and threatened suspensions for students who didn’t follow instructions from the Champaign-Urbana Public Health Distract. More than 1,000 were disciplined and some were even removed from campus by late October, but the university eventually got the students to buy into the system and now COVID is all but eradicated on campus.

Currently, students are in the midst of a two-week “onboarding” process where all students need to receive a negative COVID-19 test and are advised to only go out for essential activities. Once students have completed the protocol, the second semester will get underway with the same testing methods that made the first so successful.

Hopefully the University of Illinois continues to maintain a stronghold over the virus and many campuses across the United States adopt similar measures to keep students, staff and local communities safe.

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Respiratory Rate and COVID-19

By now you’re probably aware that the lungs are one of the organs most severely affected by the SAR-CoV-2 virus. Research has shown that the virus can cause lung damage, shortness of breath and impaired respiratory function, but what if we used these respiratory symptoms to help diagnose the condition? That’s what recent research sought to uncover.

For the study, a team of researchers examined a group of 271 individuals who experienced symptoms consistent with COVID-19. 81 eventually tested positive for the coronavirus while the other 190 tested negative, and together they provided 2,672 days of data for the study. Users were asked to wear a device on their wrist that tracked respiratory rates and other physiological measures. After looking at the data, researchers were able to develop a predictive algorithm that could spot nighttime respiratory changes that helped to predict whether or not a person was infected with COVID-19.

After looking at the data, researchers uncovered that their model could identify 20 percent of COVID-19 positive individuals in the two days prior to symptom onset, and 80 percent of COVID-19 positive cases by the third day of symptoms.

“This study presents a novel, non-invasive method for detecting SARS-CoV-2 infection prior to and during the first days of symptoms,” researchers concluded. “The findings indicate that the early stages of the infection may have a detectable signature that could help identify individuals who should self-isolate and seek testing.”

They say knowing is half the battle, and that’s especially true with COVID-19 because of the problem of asymptomatic spread. However, by looking at breathing rate changes, even in the days before symptoms set in, we may be able to determine who is infected and who should self-isolate. This non-invasive method of infection detection could radically change the game as the world waits for vaccine administration. It will be interesting to watch future studies build on this model and to see real-world applications of the system come to life in the near future.

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The research revealed that more than 10 percent of people who develop severe COVID-19 symptoms have misguided antibodies in their body. These “autoantibodies” end up attacking the immune system rather than the virus, causing even more problems for the body. They also uncovered that another 3.5 percent or more of individuals who develop severe COVID-19 carry a specific kind of genetic mutation that impacts immunity.

Because they suffer from proteins that are neutralized by autoantibodies, or because of a faulty gene, some patients suffer life threatening symptoms after contracting COVID-19, while others are asymptomatic. Perhaps most notably from the study, more than 95 percent of individuals with the autoantibodies were men, suggesting that men may be more likely to suffer severe symptoms if they contract the virus.

What It All Means

This information is a step in the right direction, but it doesn’t mean we’re suddenly going to find a way to counteract the virus. Developing a treatment that alters the immune system or attempts to make up for genetic deficiencies is obviously very difficult, but this information is still very powerful. It could help doctors identify patients who may be at a greater risk for worse symptoms should they contract the virus or once symptoms have set in. Information is power, even if we’re still working on how to best harness this power.

COVID-19 isn’t going anywhere soon, but the more we learn about it, the better we can prevent and treat problems in the thousands of Americans who contract the virus every day. Hopefully people will continue to make smart decisions about gatherings and mask use when out in public, because you may be a very healthy individual, but if you have these autoimmune disorders or genetic deficiencies, your COVID symptoms could be severe.

Please stay home if you’re feeling sick, and wear a mask when you’re in public places like the grocery store or hair salon. Buy researchers more time to better understand the virus and work towards a vaccine. Together, we can get through this, and studies that help us learn more about the virus continue to move the needle in the right direction.

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Coronavirus and Back To School

Here are some tips for helping your child or teen get ready for a return to the classroom during the era of COVID-19.

Masks – Many schools will require students to wear a mask when they are in the hallways, on the bus or in the classroom. Consider getting your child used to this sensation before you send them back to school, especially if they are young. Have them wear a mask around the house or when you’re out and about to help them get used to the sensation of a mask on their face.

Point Out The Positives – Regardless of your personal views on the situation, try to focus on the positives when talking with your children about going back to school. Talk about what new classes they’ll get to take, how they’ll get to see their friends again, and all of the fun things that go with another school year. Don’t dwell on the unknown.

Foster Open Communication – Make sure your children know that they can talk to you about any concerns they have. Honesty is very important in these times, so also talk to them about letting you know if they have any symptoms. Let them know that you’re not going to work with symptoms, and that they shouldn’t go to school if they aren’t feeling well. Make sure they know they can come to you if they have questions or concerns.

Let Them Help With Back To School Shopping – You may not be keen on heading to the normal department stores to go back to school shopping, but that doesn’t mean your children shouldn’t be involved in the process. If you’re ordering clothes or school supplies online, let them help and give their opinion. If they are excited about their new backpack or pair of shoes, it will take their mind off other things.

Hygiene – Now more than ever, it’s important that your children develop a good personal hygiene routine. Get them in the habit of washing their hands and disinfecting regularly. Not only will this help keep them safe, but it can cut down on the spread of the coronavirus to others.

Vaccinations – Make sure your child is up to date on their yearly physical and all their required immunizations before the school year begins.

If you keep these tips in mind, you’ll be as prepared as you can be during these uncertain times. For more information, or for help with a foot or ankle issue, reach out to Dr. Silverman’s office today.

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Previous stories about the virus suggested that we may be susceptible to future rounds of the coronavirus, and while we’re not out of the woods yet, what we’re seeing in patients who have fought off the virus is encouraging. In those patients, scientists are finding disease-fighting antibodies as well as immune cells known as B cells and T cells that are capable of recognizing the virus. Moreover, these cells and antibodies appear to persist for months after the infection has resolved, which is similar to how the body responds to other viruses. Researchers are hopeful this will lead to the body fending it off faster and more successfully if exposed to the virus again.

Coronavirus Immunity

The findings cannot yet be fully confirmed until a larger scale of individuals who encounter the virus a second time can successfully keep the virus at bay, but the way the body is acting is exactly how scientists hope the body would respond in terms of virus response and recognition. Recently, there have been conflicting reports about how the body may be able to recognize the virus a second time, but multiple studies are now yielding positive results.

Another key understanding will be how long antibodies remain in the body. There are different cells and antibodies with varying shelf lives, meaning a person may be immune for months, years or decades depending on a number of factors. It’s similar to why you need a flu shot every year, but other vaccines are once a decade or one and done. Hopefully our antibodies can fight off reinfection for a longer period, but it could also depend on the individual and their own cells, so we won’t have a definitive answer for a while.

Regardless, these findings are encouraging for both the development of herd immunity and the creation of a vaccine. These findings are in contrast to updated guidelines from the Centers for Disease Control and Prevention which stated that immunity may only last a few months. Many experts quickly refuted how the media was interpreting the information from the CDC, and they point to the plethora of growing information showing that our bodies response and memory to the virus is right where we want it to be.

This is great news, and hopefully we continue to learn more about future immunity to COVID-19.

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COVID-19 Vaccine

According to a recent Gallup poll, roughly one in three Americans said they would not take the COVID-19 vaccine. Here’s a look at some interesting data from that poll, which asked “Would you take an FDA-approved COVID-19 vaccine if it were available today at no charge to you?”

• 65% of Americans said they would take it, 35% said they wouldn’t
• Of those who identified as a Democrat, 81% said they’d take it.
• Of those who identified as a Independent, 59% said they’d take it.
• Of those who identified as a Republican, 47% said they’d take it.
• Interestingly, of the age groups analyzed, the group with the highest percentage of people saying they would take the vaccine were those in the 18-29 years old group (76%)
• 65% of both men and women said they’d take the vaccine.

Obviously this poll has plenty of caveats, because we know that the number of anti-vaxers in the US is far less than one in three. I’m certainly not an anti-vaxer, but I definitely wouldn’t be one of the first ones in line to get a COVID-19 vaccine. There is simply too much of an unknown risk at this time, which is why I think this poll is a little misleading. I’m confident that the numbers would be much higher if the vaccine had been proven successful on a long-term scale. Even though the question states “FDA approved vaccine”, we’re still way too early in this process to know enough about the potential long-term issues that could come with a vaccine.

A vaccine will almost assuredly help us control the coronavirus in the future, but it’s not a perfectly risk free option, which is why I believe one in three in this poll said they wouldn’t get the vaccine. It’s too difficult to put a timeline on when we’ll know enough about potential long term effects of both the virus and the vaccine. I’m cheering for a vaccine, but again, I won’t be there on the first day they are offered at the clinic either.

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The response to the coronavirus here in the United States has, for lack of a better term, been a dumpster fire. We’re far and away the country with the most confirmed cases and causalities, and based on the latest data, it doesn’t appear that cases are going to start dropping off exponentially like we had first hoped back in March. So why is the coronavirus hitting the US so strongly, and what can we do as a nation to reverse this trend and really start to see a drop off in cases? We try to offer some solutions in today’s blog.

Fixing Our Coronavirus Response

Here are some things we should strongly consider doing to help slow the spread and decrease the number of new positive cases, based on findings from what’s working in countries that have seen success.

1. Masks4All – We’ve talked about this in depth on the blog in the past, so we won’t go too deep here, but #Masks4All needs to catch on when we are in enclosed public places. That means banks, grocery stores, gas stations, retail stores or any place where you can expect more than a few people inside an enclosed space. The data shows that masks can help protect others, so if we all do our part, we’ll greatly reduce our likelihood of transmitting the virus if we knowingly or unknowingly come down with it.

2. What’s Necessary – We really need to take stock of what’s necessary in our lives. Right now, we don’t need to be going out in droves to church or the bar. Trust us when we say we understand the financial implications another shutdown would have on small businesses, but there are other ways to patronize businesses than to belly up at the bar or book a hair coloring session right now. Takeout orders and buying gift cards can all help support local businesses without greatly increasing your risk of catching COVID.

3. Trust The Good In People – One of the prevailing sentiments in the US seems to be that “well if others aren’t social distancing or quarantining, why should I?” After all, we’ve all seen the news coverage of beaches in Florida or packed bars. Know that this is not a representation of the majority of people. Most people are practicing smart habits when it comes to COVID-19, but that doesn’t garner eyeballs and clicks on news websites. I’m sure you know some people that aren’t really following the guidelines, but odds are you know more people who do take basic precautions. Even though they aren’t on the news or filling your Facebook timeline with rants against masks, know that a large portion of the US is taking this seriously, and you should too.

4. Long Term Over Short Term – We know that it’s frustrating to miss out on summer activities like sports games, weddings and backyard barbecues, but we need to put long-term goals over short-term rewards. We may not get to a place where we are comfortable reopening schools in the fall, but we’re not going to get there if we keep putting big weekend gatherings and social events over bigger future goals. Do your part, don’t give in just because a few outliers aren’t doing their part.

5. Go Digital – The internet makes it so much easier to get things done or connect with people, so utilize online options to reduce your need to meet people face to face. Buy groceries online, support small businesses on their websites, set up a telemedicine appointment and connect with friends over Zoom. Lean into technology so we’re still together as the virus keeps us apart.

We’re not saying we have all the answers, but if we all do our individual part and keep these tips in mind, we will win out over this virus. If you have questions or need help with a foot or ankle issue, reach out to Dr. Silverman’s office today.

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The chart was put together by more than 500 epidemiologists and health professionals, so we can trust that it’s rooted in concrete science. Below, we take a closer look at the chart and add our insights to the findings.

What’s Safe And What Should Be Avoided?

As you can see by the chart below, COVID-19 risk really increases as you head inside and your gathering gets larger. If possible, strive for outdoor activities with immediate family or a small group that has been taking precautions. And always wear a mask when in places like grocery stores or department stores!

As you can see, some of the low risk activities that you can still smartly engage in include:

• Golf
• Tennis
• Outdoor Exercise
• Camping
• Seeing Your Doctor

As we move to the right, we can start to see why some of these activities are considered a little riskier. You’re in places where more people have been, like a playground, a restaurant or the office, or you’re inside at a mall or small dinner party. As we get to the high risk activities, we see actions that could easily put you at risk for coming in contact with COVID-19, like visiting a buffet, attending church or having a large indoor party. High traffic, indoor locations will continue to be hubs for the spread of the virus, so be smart how you approach these areas. Avoid if possible, but if you can’t always wear a mask!

For more information about activity risk or to set up that low-risk visit with your foot and ankle specialist, reach out to Dr. Silverman’s office today.

The post Which Activities And Places Are The Riskiest For COVID? appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

The Curve Isn’t Dropping Like Other Countries

The majority of the United States has done a good job at flattening the curve, in that most hospital systems have not become overburdened by patients who have contracted the virus. However, the latest data suggests that while we’ve flattened the curve, we’re not experiencing the drop off in cases like many other nations who have also sought to flatten the curve and reduce the number of new cases.

This chart shows the reported number of new and total cases, along with the death totals in the Italy, Germany, Spain and the United States. Clearly, we’re doing something wrong.

You can argue that our reporting measures are better, that we’re testing more patients or that we’re simply a bigger nation, but that still doesn’t explain the monumental differences between new case development. It seems likely that our lag in our willingness to wear masks out in public played a role in why our curve looks so different from the others.

Earlier this week, the US Surgeon General announced that masks help to promote freedom, but it shouldn’t have taken until mid-June for this sentiment to be championed at the highest level and understood by the masses. Masks help to stop the spread when we must travel to public places like grocery stores. It’s such a simple move that has been better adopted in other countries, and it’s likely why we’re not seeing the success they have had in controlling the virus.

With the weather only getting nicer, it seems likely that Americans will continue to go about their business with one another. Hopefully more of them adopt masks in these public places, otherwise our coronavirus chart is unlikely to change much.

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You can check out the full presentation here, but we thought it would be a good idea to list some of the main takeaways from the presentation, especially because their thoughts fall in line with what we plan to practice as surgeries begin again. Below is a recap of the presentation “Ortho & Spine Surgery In The Times Of COVID-19.”

Returning To Normalcy And Keeping Patients Safe

Here’s a look at some of the takeaway points of how we can safely reopen our clinics and get back to providing care for patients undergoing necessary and elective surgeries.

1. Postpone Elective Surgeries For The Time Being – Until we learn more and can safely see how some countries and facilities are performing safe elective surgeries, we should postpone most elective surgeries. Elective surgeries can wait, so there’s no need to rush into an operation when we’re still learning the best ways to keep patients safe when the surgery isn’t necessary in the moment.

2. Patient Screening – We need to make sure that we’re effectively screening patients who are coming into our clinics as we’re allowed to have more patients in house. Temperature checks, symptom screening, patient questionnaires, etc. We need to do everything we can to ensure only healthy patients come into the clinic to minimize the spread to others.

3. Prioritize Elective Surgeries – Even though they are all categorized as elective, all elective surgeries aren’t the same. Doctors need to prioritize patients for these operations in a safe manner. They need to consider who needs them most, their COVID-19 risk, their potential for complications and whether or not postponing the operation longer could put their condition in a more difficult state to operate on in the future.

4. Keep Learning – The landscape of elective surgery is always changing during the pandemic, and we need to be ready to adapt as we continue to learn more about the virus. Every day doctors and healthcare providers need to research new critically-sourced information to ensure our patients are getting the care they deserve.

5. Sanitize, Sanitize, Sanitize – Finally, we need to make sure we’re sanitizing as much as we can between patients. Cleaning our lobbies, our waiting rooms and our exam rooms at regular intervals is essential for helping to decrease the ability of germs to spread between patients.

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