- The Washington Times - Tuesday, April 21, 2020

As parts of the U.S. attempt to gradually reopen, many questions about COVID-19 are still up in the air.

The coronavirus has sickened more than 804,000 and killed more than 43,000 in the U.S. as of Tuesday, according to the Johns Hopkins University coronavirus tracker.

Here’s what the experts say about immunity, testing, contact tracing, treatments and reopening businesses.

What about immunity?

A lot about immunity and COVID-19 is unknown. Cases of South Koreans who have recovered and tested positive again raise questions about reinfection, but health officials have said that’s unlikely. Experts have said it could be that remnants of the virus are left over in these patients or that lab or testing errors occurred.

If a person can develop immunity to the coronavirus, it’s a mystery as to how long that protection can last. Antibody testing is underway to learn how many people have gotten sick, recovered and developed antibodies against COVID-19.

Achieving herd immunity, or community protection, against a contagious disease is not in the near future, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University.

He said epidemiologists estimate that less than 10% of the U.S. population has been infected and that 90% of the population is still susceptible to the coronavirus. To achieve herd immunity, some epidemiologists estimate about *70% of the population need to be infected with COVID-19.

A vaccine won’t be available for months, as it undergoes development and clinical trials, he said.

What about testing and contact tracing?

Health experts say robust testing and contact tracing should be in use for parts of society to reopen gradually.

According Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention, the number of tests being done daily could increase three- to 20-fold compared to the number of tests done in mid-April, which he said was fewer than 150,000 per day.

He said the top priority should be to test every person with pneumonia, every sick health care worker, every ill person in nursing homes and other congregate facilities, their contacts and people in clusters of suspected COVID-19.

Ideally, every person with symptoms and many more at risk could be tested, Dr. Frieden said.

As of Tuesday, more than 4 million people in the U.S. had been tested for COVID-19, according to the Johns Hopkins University coronavirus tracker.

Dr. Frieden said all contacts of infected people must be traced, warned of their exposure and quarantined.

“People who came into contact with cases and may have been infected are the leading edge of the pandemic,” he said.

A person with COVID-19 can infect two to three other people, which translates to more than 59,000 cases in 10 rounds of infections, says a national plan by the Johns Hopkins Center for Health Security and the Association of State and Territorial Health Officials (ASTHO).

The plan estimates that the public health workforce needs to scale up tracing efforts by recruiting an additional 100,000 contract tracers.

What treatments are being tested?

Several therapies for COVID-19 are undergoing development and clinical trials, including plasma therapy, a monoclonal antibody, remdesivir and hydroxychloroquine.

Hydroxychloroquine, an anti-malarial drug touted by President Trump, showed no benefit in an analysis of 368 patients in U.S. veteran hospitals. The researchers reported there were more deaths among those given the drug versus those offered standard care.

What precautions should businesses take to reopen?

Most U.S. workers will face low or medium risk for exposure to COVID-19 at their jobs and workplaces, according to the Occupational Safety and Health Administration.

Dr. Schaffner said employers should instruct workers to routinely wash their hands and wear face masks. He said employees should be taught how to properly wear face masks to ensure they are covering their mouths and noses. Employees should practice social distancing by staying 6 feet from others, he said.

“Introducing these notions as the new norm, I think, will be important and employers are going to be key because the employees will follow the guidelines of the employers,” Dr. Schaffner said.

Dr. Frieden said there should be mandatory temperature checks for employees and placement of hand sanitizers at every building entrance.

The CDC recommends people avoid touching their faces, cover their coughs and sneezes, disinfect frequently touched objects and surfaces and avoid using other workers’ phones, desks, offices or other equipment.

More remote working and virtual meetings and less business travel could be part of the “new normal,” Dr. Schaffner said, adding that these precautions are something society could maintain after the pandemic subsides.

* (Correction: The story has been updated with the correct information regarding herd immunity and COVID-19.)

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