OU Medicine hosted a COVID-19 round table discussion with Oklahoma medical experts to outline the virus’ statewide impact, treatment methods and the future of vaccines.
OU Chief COVID Officer Dr. Dale Bratzler said within the past month, Oklahoma has seen a rise in positive cases and hospitalizations. Bratzler said 1.8 percent of tests completed in the week of May 25 were positive, while today’s percentage of positive cases has risen to over 7 percent.
Currently, positive COVID-19 cases are at the highest daily rate yet at 585 new cases. The seven-day average, furthermore, is at the highest seven-day average of 389 new cases to date.
In cities like Tulsa, OU’s associate program director of the School of Community Medicine Jabraan Pasha said the rise in positive cases cannot be attributed to increased testing. Increased population densities and a lack of practiced caution, rather, are fueling the spread.
“Clearly, (cities like Tulsa and Oklahoma City) seem to be driving the state’s numbers … which shows part of it has to do with … (their) population densities,” Pasha said. “Otherwise, there aren’t many factors that seem to be sticking out as to why (Oklahoma) is having a hotspot … (but) across the board, we aren’t pleased with the caution individuals are choosing to take.”
Younger individuals specifically are contributing to this rise, as 34.6 percent of total cases in Oklahoma occur within the 18–35 age range, according to the Oklahoma State Department of Health’s executive reports. Pasha said while older individuals' increased risk causes them to heed medical professional’s advice, younger populations are driving COVID-19 numbers.
Minorities have also contracted COVID-19 at remarkable rates, Pasha said. Positive cases within underrepresented populations, he said, can be attributed to their increased likelihood of having more than one chronic illness and because they are often continuing to work on the frontline.
Pasha said racial disparities aren't unique to COVID-19, but he is hopeful the virus will shed a light on existing disparities in public health.
“(Minority communities) tend to have more socioeconomic stressors … (meaning) that economic cushion many of us have had to rely upon during the shutdown may not be available to (them),” Pasha said. “They have had to go to work, and when they go to work, they often are in positions where they come in contact with a lot of individuals.”
Contact tracing — a process where tracer groups warn the people an individual has been in contact with of their illness — has become crucial in curbing the number of COVID-19 cases, OU Hudson College of Public Health associate professor Aaron Wendelboe said.
“(Back) in March when we had a full economic shutdown, that was the worst-case scenario because we didn’t know where the virus was,” Wendelboe said. “In contrast, when we know who has tested positive, we can focus on those people … identify who they have come into contact with and stop them from contacting others. That’s essentially the best way we can avoid what happened in March.”
As medical professionals continue to address the virus, treatment algorithms have changed immensely. OU associate professor of medicine Jennifer Holter-Chakrabarty said because of COVID-19’s high mortality rate and limited surrounding data, Oklahoma professionals have consistently adapted treatment plans.
“Sometimes (OU) was using medications that did not have the strength we normally rely upon,” Holter-Chakrabarty said. “(But) as data came in, we saw clinical trials that proved they were ineffective. We had to change our treatment algorithm and move to more reliable therapies.”
Recent studies have shown cheaper and more accessible forms of treatment like dexamethasone can be used to combat an overactive immune system response, which is often seen in COVID-19 patients, Holter-Chakrabarty said. As treatments continue to change, Holter-Chakrabarty said it’s important for professionals to continue screening data and implementing high standards as they research.
“You can't just see a single study, think it looks good, not look at the data clearly, and then jump,” Holter-Chakrabarty said. “You have to look at it and critique it well before you make changes ... (which is why) we have a treatment task force … to help create our treatment algorithms. … I think that is why we've had limited mortality at the University of Oklahoma.”
While looking into treatment methods, OU Medicine officials are also studying the long-term effects of the virus. In working with patients, Bratzler said he has been surprised by the patients who experienced long-term symptoms like blood clots, persistent weakness, headaches and dizziness.
“I saw a patient early in the course of their illness … who is a very avid runner,” Bratzler said. “(They) had this remarkable aerobic capacity and could run long distances. (They) were very sick with respiratory symptoms … and after the infection recovered … (they) had severe limitations on (their) ability to run … because of the persistent shortness of breath that lasted several months after their recovery.”
An understanding of the long-term effects of COVID-19 is still being formed as professionals discuss the application of long-term data at the state and national level, Holter-Chakrabarty said. OU Medicine’s task force is conducting a long-term study following COVID-19 patients in hopes of identifying the long-term consequences of this virus.
Long-term consequences, however, require plans for long-term prevention — which, concerning COVID-19, means the development of a vaccine. Although the fruit of these plans won’t be realized until around 2021, OU Health Sciences Center professor William Hildebrand said there are more than 150 current vaccine initiatives, with 15 in clinical trials.
Hildebrand said he is currently working alongside OU faculty and third-party biotech companies to select typical candidates for COVID-19 vaccines, take samples of the virus from them and put samples into various vaccines. He said he hopes this will allow OU to successfully target the virus.
“In the event we’re not targeting COVID-19 the right way with this current generation of vaccines, we are trying to understand what is the right way to target the virus,” Hildebrand said. “So that is what I’ve been involved in and what I understand other people have been involved in on campus — building the next version of vaccines.”
Several national vaccines are in phase two trials, meaning they are being given to a select group of people. Furthermore, one vaccine is in phase three, which means it is being tested on thousands of people for efficacy and safety, Hildebrand said.
AstraZeneca is directing the phase three vaccine, with the help of Operation Warp Speed — a partnership of federal agencies aiming to deliver 300 million doses of a safe, effective vaccine for COVID-19 to U.S. citizens by January 2021.
“Operation Warp Speed pumped $2 billion into supporting vaccine initiatives and the AstraZeneca vaccine is … (being) supported by more than a billion dollars in U.S. taxpayer dollars,” Hildebrand said. “They've invested in vaccines and, (when the time comes), they'll be able to make many copies of them quickly.”
The normal timeline for the development of a vaccine is 7–10 years, but Operation Warp Speed is currently pushing to make a vaccine within the next 12–18 months, OU Health Sciences Center assistant professor James Papin said. Although the process is shortened, Papin said the public can still expect to have a quality vaccine.
“Companies who invested in these high-quality candidates are very familiar with the (FDA screening process) and are working hand in hand with the FDA to expedite (it),” Papin said. “The high volume of money that has been injected in a short period of time for the development of these vaccines … should ensure that we can move these along the pipeline as soon as possible.”
Pasha said, however, Oklahoma is still in the middle of a pandemic, meaning the “magic bullet cure” necessary for the state to move on has yet to be found. As medical professionals continue to search for this cure, Pasha said he encourages people to continue partaking in precautionary measures like social distancing and wearing masks.
“You just have to assume that a stranger you may be coming in contact with or a person that lives outside of your household has COVID-19 and you should practice social distancing and mask up,” Pasha said. “I think if everyone would practice universal precautions, we would have better luck with keeping our numbers down.”