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Newell: Louisiana reaches encouraging milestone in coronavirus battle

Dr. Joe Kanter calls progress since April 'remarkable'

Newell Normand
May 21, 2020 - 4:41 pm
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Louisiana’s Assistant State Health Officer Dr. Joe Kanter joined Newell for his recurring weekly segment Thursday morning to discuss the latest developments in the battle against COVID-19, preventative measures, and the search for effective treatments or even a vaccine. This week,  there is something to celebrate.

“Doc, for the first time in a long time, we have fewer than 1,000 COVID patients in our hospitals. What does that mean for us?” Newell began.

“It’s a good marker!” Kanter said. “Not that long ago, only four or five weeks ago, we had COVID patients just completely filling our hospitals, so it's quite remarkable to see where we are at now. The number of COVID patients in New Orleans hospitals has come down pretty steadily since April 7th, over a month ago. Then, we had over 1,000 just in region one, and yesterday’s numbers were about 250. Even more remarkable is the number of patients on ventilators. At our peak, that number stood at somewhere near 250 or 260, and now it’s below 20. That’s just remarkable. We have come a long way - we hope we don’t backtrack on that.”

“There’s another study out about something a number of physicians are saying that they have never seen before,” Newell continued. “The manner in which the virus actually hijacks cells, and the viruses’ ability to make millions of copies of itself if interferons invade them. Can you help explain that?”

“In general, one of the complicating factors in treating COVID patients is that a week or so into their symptoms, some patients get this inflammatory storm,” Kanter said. “A bunch of cytokines get produced, interferons get ramped up, and the body just goes into overdrive and goes haywire. The thought is that it happens in part because the virus is attacking cells, and also because the body’s defenses are overreacting. Both of those processes are damaging. Early on, there was a hope that maybe steroids could help tamp down on that. Steroids decrease the body’s immune reaction, but early studies didn’t show any benefit to using them. There still isn’t a great way to treat this, but clinicians will tell you they have patients on the regular hospital floor, not in the ICU, for about a week or 8 or 9 days, doing okay, plateauing with COVID, and then at the 8 or 9 day mark, a small subset of them just tank and take a turn for the worse.. We don’t really know how to predict that, we haven't figured out which patients are going to do that.”

“About these superspreader events, a group of researchers have gone back to trace what happened in Italy, South Korea, China and others,” Newell said. ”These superspreader events are really more about close contact than it is about large numbers, because there was one party, a social dance, in Germany with fewer than 100 people and the next thing they knew, the disease had run amok in this community. When we think about those events in relation to tracing - do you think we can get to the point in the US where we will have enough tracing capacity to beat this back and have large events again?”

“I do,” Kanter answered. “Part of the hope with contact tracing is that you let people who were exposed and may be asymptotically infected know that they may be at risk of spreading it, and that they have to stay home. At this point, I think it’s safe to say that if folks are sick they are going to stay home and not put others at risk. So the big challenge now is the asymptomatic people can spread this, and that’s where contact tracing comes in. Without it, you would have no idea you were directly linked to a confirmed case. One of the things that happens in these superspreader events is that you have a confluence of unfortunate circumstances - people in close proximity doing high-risk activity like singing, but you also have the infectious individual at the peak of their infectiousness. You add those two together, and by luck, you get a superspreader event.”

Hear the entire interview in the audio player below.

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