OU health officials held a press conference Tuesday morning announcing that OU Medicine is working on a coronavirus vaccine and answering questions on treatment and precautions to take as the disease develops.
Jason Sanders, senior vice president and provost of the OU Health Sciences Center, said OU Medicine is working on two agreements that will help facilitate the creation of a vaccine for the coronavirus. The announcement came as the Oklahoma State Department of Health reported that the number of confirmed cases in Oklahoma had increased to 17 from 10.
“We’re not surprised,” Sanders said. “We’re prepared for this — as you’ve heard, that data already lags several days, and the actual number of cases is higher than that because of what we discussed in lack of testing.”
Dr. Douglas Drevets, OU College of Medicine regents professor and chief of the Section of Infectious Diseases in the college, said testing looks backward five to seven days since it takes about five days for people to start showing symptoms and usually two days for testing to be confirmed.
Multiple doctors and health officials emphasized the importance of social distancing and proper precautions like repeated hand-washing to prevent infection, and they spoke about how previous diseases — such as H1N1 and influenza — can inform people's actions moving forward.
OU public health epidemiologist Aaron Wendelboe said COVID-19 is different from other pandemics over the past 20 years, such as Zika, SARS or H1N1, because of its “unique combination of being severe but not too severe, along with being highly transmissible.”
“This has made responding to COVID-19 a challenge,” Wendelboe said.
Wendelboe said, in 2003, SARS was more severe than COVID-19 since it had a higher case fatality rate, but because of that, more cases were detected and medical professionals were more easily able to track and prevent further transmissions. He said 2009’s H1N1 outbreak turned out to be not as severe, so it did not end up stressing the public health system in the way COVID-19 has.
“COVID-19 … is severe, but not necessarily severe in everyone,” Wendelboe said.
Wendelboe said this pandemic’s development is difficult to predict because it depends on what the public does today, but two primary factors will affect what happens going forward: known transmission and unknown transmission of the disease, which is also known as community spread.
“From the first time the U.S. saw a case of COVID-19, we were able to identify the source of transmission for every case for approximately a month. During that time, we had a slight increase in the number of cases,” Wendelboe said. “About three weeks ago, the U.S. had the first case of COVID-19 with unknown transmission. … When this happens, it makes it difficult to identify every single case in the community and therefore prevent transmission.”
Wendelboe said the time it takes for cases to double is crucial in measuring the development of a pandemic, and that health professionals are trying to make that doubling time closer to an 8- to 10-day span rather than 2 to 3 days. He said they expect about 10 percent of detected cases to be hospitalized, and that 80 percent of cases are expected to be mild, 15 percent are expected to be moderate, and 5 percent are expected to be severe.
“The death rates we can expect will again depend on what we do today,” Wendelboe said. “Overall, 3 percent of detected cases may die. This will range from less than 0.1 percent to 15 percent where increasing age increases your risk of death. For this and other reasons, we're working with everyone to prevent as many cases and deaths and slow the growth of this pandemic.”
In response to a media question about St. Patrick's Day celebrations at bars and restaurants on Tuesday, Drevets recommended people consider the potential impacts their actions may have.
“They need to think about what the downstream consequences of this is,” Drevets said. “As Americans, we value our freedoms and our personal independence. … The best advice I can give (people who still want to go out) is to think through the consequences of your decisions.”
Wendelboe added that people are “generally very terrible at assessing their own risk,” and that people may think the situation in Oklahoma is not that bad due to the delayed reported numbers of cases, which does not actually reflect what’s happening in the community right now.
“It’s important to understand that when you have the news indicating that there’s only 10 reported cases and people may be a little bit complacent about that, understand that 80 percent of people have mild symptoms,” said Dr. Morris Gessouroun, Chair of Pediatrics for The Children’s Hospital at OU Medicine. “Children have virtually no symptoms but are carrying the virus and can spread it. … We don’t really know how widespread this is right now (due to limited testing).”
Dr. Rodney Edwards, chief of maternal-fetal medicine at The Children’s Hospital at OU Medicine, explained that unlike some other viruses, there is no known vertical transmission from mothers to fetuses during pregnancy or to infants during birth. But to be cautious, medical professionals are considering pregnant women potentially at greater risk of becoming more severely ill.
Edwards said this is just something they are considering when evaluating if symptomatic pregnant women would need to come to the hospital.
Drevets said exposure to COVID-19 can vary in terms of risk, but generally all it takes is exposure within six feet for longer than 30 minutes to spread the disease.
“Not all exposures are the same,” Drevets said. “Typically, high-risk exposure would be ... if you're in a close proximity, meaning within six feet for a prolonged period of time with someone with a known case of the disease. … Remember also that not all exposures will necessarily result in infection. And not all infections result in symptoms and disease.”
Although testing is important, Drevets said, those with minimal or no symptoms should not rush to get tested, as it would overwhelm the limited testing capabilities available. But if someone showing symptoms is at high risk of developing severe disease — such as a person over the age of 65 or who has pre-existing conditions — they should contact their health care provider.
Testing negative for the disease once will not give people a pass that they will not develop the disease in the coming months, Drevets said.
“It is very important to get testing, that we have the ability to test large numbers of people,” Drevets said. “What we're doing now, in terms of limiting testing, is largely because we don't have enough tests. … We hope that much of these guidelines and much of our guidance will evolve over time. We're really trying to prioritize testing for the people that we really have to know if they have COVID, or if it's influenza, or bacterial pneumonia or something else.”