COVID-19 treatment methods, case counts in the Kansas City metro area and the statuses of possible vaccines for the novel coronavirus were some of the key areas of discussion by KU Health System professionals at a webinar roundtable Wednesday.
Co-hosted by the chambers of commerce in Shawnee and Kansas City, Kansas, the webinar featured the following KU Health professionals who provided updates on the COVID-19 pandemic during the webinar:
- Amanda Gartner, RN, Director of Quality and Safety
- Dana Hawkinson, MD, Medical Director of Infection Prevention and Control
- Chris Wilson, Vice President System Integration and Innovation
A video recording of the webinar is available to view on YouTube. Below is a breakdown of the main topics.
Cases and testing
Hawkinson said the Kansas City metro area has fewer cases per day on a rolling 14-day average since late July, but the area still has about 400 cases per day. At this time, the area still has a lack of testing capacity “for various reasons.” Hawkinson added that they would like for everyone to get tested so officials can get a better idea of the spread of COVID-19 in the area.
There are three main types of testing:
- Polymerase chain reaction (PCR), a nasopharyngeal swab that identifies if nucleic acid is being shed by the virus
- Antigen testing, which identifies proteins from the virus
- Antibody testing, which identifies if a patient previously had an infection from COVID-19
Wilson stressed the value of the Johnson County Department of Health and Environment and other county health departments, which can provide up-to-date information on isolation and quarantine, when to test and when not to test, etc.
Treatment and vaccines
Hawkinson said the anti-viral Remdesivir is the only approved treatment for the novel coronavirus, although other treatments may be on the way, including old drugs that may be repurposed. Other drugs include:
- Dexamethasone, a corticosteroid
- Convalescent plasma, a blood product from recovered patients
- Anti-coagulation, which prevents or manages blood clots
At least 12 vaccines “look promising” and are in phase two or three of trials right now, Hawkinson said. Russia and China have announced progress in vaccines; he noted these have not been vetted or studied yet.
KU Health is also enrolling people in its own vaccine trial.
“We are working nationally and internationally in doing our part to really try and stem the tide of this infection,” Hawkinson said.
The KU Health System officials stressed the importance of non-pharmaceutical interventions to stop the spread of COVID-19. These include promotions of:
- Mask wearing
- Physical distancing
- Avoiding large groups
- Hand washing
“All those infection prevention practices are critical,” Wilson said. “They don’t just need to exist in large groups, they don’t just need to exist inside of healthcare settings, they need to exist everywhere that we are.”
Wilson stressed that patients are highly infectious in the one or two days prior to showing symptoms, which is why widespread testing is critical, even for those showing no symptoms.
Questions and answers
21:10 What are the requirements to enroll in the clinical trial? Details are on KU Frontiers’ website and at Coronavirus Prevention Network’s website. KU Frontiers hotline is (913) 293-1833. Hawkinson said they want clinical trial patients who are more likely to be exposed to the coronavirus (not necessarily groups who are being vigilant with social distancing and wearing masks).
22:47 What is the University of Kansas Health’s position on HCQ? Hawkinson said further studies that are validated have found that Hydroxychloriquine didn’t lead to a reduced mortality, hospitalization, but it did increase risk for heart complications. KU Health doesn’t recommend it and “it can be dangerous,” he added.
25:10 At what point does herd immunity start to take place before a vaccine is ready? Is it actually realistic that we could achieve that? Hawkinson said herd immunity is likely reached after an infection spreads to 80 to 90% of a population. The circumstances of herd immunity are unknown, which is why vaccination is important. It’s unknown how frequent a vaccine should be administered.
27:50 As a metro, why are we not getting (updates on) daily current hospitalization, ICU and ventilator? Gartner said KU Health System shares this information each morning in media briefings. These can be viewed on Facebook. Wilson said the KU Health System encourages transparency in this area, although it has been politicized recently.
30:20 (On challenge trials) could this be a method to streamline the most effective therapy/vaccine to this pandemic? Hawkinson said a challenge trial gives a participant an experimental vaccine and exposes the participant to COVID-19. These are not being performed due to the risk.
32:45 Saliva testing was just recently approved by the FDA as a method to do mass, cost-effective testing at a relatively high effective reliability rate. Is this now a game changer in the testing arena? Wilson said yes, though KU Health System still recommends the nasal swab as a preferred method of testing. For broader testing initiatives (such as schools returning to class this fall), saliva testing could be an option. It can be self-administered. Mass testing on the Lawrence campus prevents long wait lines, Wilson said. Yale recently announced progress in this area.
37:15 Can you explain the differences between the different types of vaccines that are being developed? Which ones are the leading candidates? Hawkinson provides a breakdown of the types of vaccines.
41:10 Can you provide guidance on when an employee tests positive, what are the steps employers should be taking? Gartner recommended contact tracing through the Johnson County Department of Health and Environment. The state of Kansas considers a close contact to be someone who is within 6 feet of an infected person for at least 10 minutes, or exposed by being sneezed or coughed on by an infected person. Close contacts would have to be in quarantine for 14 days. Wilson added that Kansas asks people to stay in quarantine for 10 days if asymptomatic, and 72 hours after symptoms are gone.
47:26 Can you discuss the changes you are seeing in the populations contracting the virus (age, ethnic background, etc.)? Gartner said they initially saw older patients but are now seeing anyone from teenagers through age 99. College students in Lawrence as well as young children and teens have also been infected, especially this summer and with the reopening of schools. Hawkinson added that white/Caucasian populations were the most common demographic at first of their patient population, but they now see “quite a few” Black patients as well. Beginning in June and July, they’ve also seen more Hispanic patients.