Iowa Specialty Hospital

COVID-19 Update from Dr. Michael McLoughlin 11/30/2020

November 30, 2020

Over the last week, we have finally seen some reduction in the number of cases and hospitalizations due to COVID across the state. This is certainly welcome news that suggests that more precautions are being taken and that it is working. While good to celebrate some improvement in the situation, it is important that we continue to focus on the big picture. Unfortunately the big picture is still that the number of new cases in the state averaged over the past 14 days is still roughly 3 times higher than it was as recently as October. We are also seeing deaths from COVID-19 increasing, which is expected since deaths always trail an increase in cases by several weeks. Finally, we won’t know for a week or two what is going to happen due to the Thanksgiving holiday but there’s reason to be concerned that any increase in gatherings, especially if held without consistent use of masking, will send the numbers right back up. So, we need to continue to be vigilant in all the same ways, reducing close contacts from outside our households and having everyone mask when a 6 foot distance can’t be maintained.

In Wright County specifically, there has not yet been a clear decrease in the number of cases and we currently have 6 patients hospitalized due to COVID.

One of our employees this week asked for some information about what we know about the time period after someone has had COVID. It’s a timely question since more and more people in our community have had COVID and may have questions about whether they have immunity or can change their behavior. There are two important questions in this. First, what is the personal risk of severe illness with the second infection? Second, what is the risk of transmitting to others with a second infection? We have some information about the first question, but precious little about the second because the kind of careful study that it takes to answer it is difficult and takes time. March 17th was the first day that over 1000 cases were detected in the United States, so there has been only about 8 months where a significant number of people in the United States have been infected.

We do know that people can be re-infected with COVID, but it appears to be rare that the second illness will be severe. This is what we’d expect as we’d expect them to have some degree of immunity. Whether the risk of a severe second infection would still be low a year or two out from the first illness simply can’t be answered yet, but it is likely that immunity will start to “wear off” to some extent at some point after the first illness.

The most important question is probably whether a person can still transmit COVID-19 after having had it once. And on this point, we simply don’t know. Particularly since many people who have a second infection will have mild or no symptoms and may not get tested, it’s very difficult to determine whether they are transmitting the virus to anyone else. Similarly, we don’t yet know whether people who have been vaccinated will be able to transmit to others and this will be very important to understand. So, for now, the recommendation is to follow the same precautions of social distancing and masking that we’d ask of anyone.

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