A technician works in the lab of the COVID-19 department of the Policlinic of Tor Vergata in Rome, Friday, April 17, 2020. – CopyrightMauro Scrobogna/LaPresse
With all the information circulating on coronavirus, it can be hard to sort fact from fiction. In our latest Q&A we asked our experts to answer your questions.
Our experts this week are: Dr Muge Cevik, a clinical lecturer in infectious diseases and medical virology at the University of St Andrews School of Medicine and Christina Scaduto, an expert in data analytics and infectious disease from the Havard School of Public Health.
What are the biggest scientific breakthroughs concerning the virus so far?
“Over the last 3 months we’ve seen extraordinary scientific progress,” Dr Cevik said.
“The virus genome was shared with the world immediately. And within 18 days we had the first diagnostic test.
“Since then we now know how the virus attacks the body (…) and we have extraordinary data, more than 3,000 articles trying to understand the clinical progress of the virus so I’m quite optimistic about where we are at from a scientific perspective.”
Scaduto said: “I think that this is an unprecedented time for everybody but in terms of scientific knowledge and data that’s been collected so rapidly within the last few months, it’s something that we’ve never seen before.
“If this pandemic had happened 30 years ago I don’t think we would have the type of access to information and data that we’ve seen today.”
What about treatments, what is giving you hope?
“I think it’s important to emphasise that, at present, there are no approved anti-virals or treatments for COVID-19,” said Dr Cevak. “Several anti-virals have shown promise. There are actually quite a lot of clinical trials in progress. I think it’s too early to comment on these new antivirals we need to see the randomised control trial data.”
“For most of the patients that we are treating on a daily basis we provide supportive care which includes oxygen, fluids and sometimes antibiotics if they have bacterial infections and when they’re in intensive care units they can be given supportive care and additional antibiotics, for example but at the moment I think it’s too early to comment on these new treatments.”
How is all this data collected and used to help pin-point treatments and vaccines?
“The way that we collect this information can vary from country to country,” said Scaduto.
“Data and science are often viewed as a universal language and can be viewed as one objective measure.
“But there are issues with data biases and data quality. All lot of it is stemming from not testing enough people. Also we truly do not know the number of people who have this virus.
“But healthcare data is notorious for being complex and being all over the place and for us to ensure that we are collecting this data, we also need to ensure that the quality of this data is optimal.”
Tracking apps have been used in several countries to help stop the spread of the virus but what if not enough people download it to get relevant data, are there any incentives in place to encourage people to use them?
“At a minimum 60 per cent must download and use these apps. But what’s really challenging is that with contact tracing, you can’t compare apples and oranges,” said Scaduto.
“There are a lot of cultural differences between some of these countries. In Asia, we have seen technologies like this before and in Singapore, for example, the government is really taking ownership and using these contact-tracing apps.
“But it’s definitely a two-way street. There needs to be leadership and buy-in from the government but there also needs to be buy-in from its citizens.
“And I think that in places like the US (…) it might be a little more difficult to implement this. The US is a very diverse place and a large country so there are many cultural differences that we have to consider when we’re thinking about developing these apps and it’s not just about the technology, we really have to consider the end-user and the patients first.”
What about Donald Trump’s suggestion that UV light or detergent could help treat the virus? How dangerous is it when a world leader steps in like that and talks about possible treatments and is there any validity to what he’s saying?
“I am extremely worried about this statement and we need to be clear that under no circumstance disinfectant products should be administered into the body, through ingestion or injection or any other route?” said Dr Cevik.
“Disinfectant and detergents should only be used as intended, only externally to clean surfaces and hands. These are really toxic substances and can be corrosive when ingested. It can burn the respiratory tract and the digestive tract.”
“So I think this kind of rapid and unregulated spread of misleading or false information is very dangerous. This can cause direct harm, almost 300 people have been killed in Iran by ingesting methanol or bleach. And this false information generates confusion and obscures the delivery of key messages and can cause public reluctance to adopt well-founded practices like social distancing and hand hygiene”.
Should we be focusing more on those who are recovering from the disease? Have a more positive outlook?
“We are seeing many people recovering, in some countries the curve is starting to flatten but we really need to disaggregate this data by gender, different demographic groups, by age and sex,” said Scaduto.
“In places like the United States, we are seeing differences in outcomes depending on race and people’s economic status and neighbourhoods that they live in.
“Your postcode can determine what your life expectancy is in some of the US’s major cities.
“So even if we are seeing high levels of recovery at an aggregate level, what does that say about the African American community in the US which has been predominantly hit by this virus with the highest mortality rate?”
“We really need to drill down on the data at look at as closely as possible.”
Dr Cevik said: “What we need to understand is that most of this data is coming from patients who are unwell and are presented to hospital.
“Most of the countries at the moment are not doing community or widespread testing so we don’t actually know how many patients are out there.
“There are many tests in development to test for antibodies to check whether someone has been exposed to the infection. So this can tell us how widespread the infection is and can tell us how many patients recover without needing hospital care”.
“So once we have this information we’ll have a better understanding of the recovery rate.”