MUSC experts discuss the latest on the coronavirus during virtual TEDxCharleston

As COVID-19 cases in South Carolina spike, two Medical University of South Carolina researchers urged residents to do their part in fighting the virus. 

“In this pandemic, it’s paramount that we take care of each other. It’s very important to set our own comfort aside sometimes – wearing a mask makes it hard to breathe – but it’s important that we take care of each other so we can all get through this,” said Satish Nadig, M.D., D.Phil., an immunology researcher and transplant surgeon who spends a good amount of his work hours wearing a mask.

“Mask wearing, hand hygiene and physical distancing – those three steps will greatly help contain this pandemic,” said Michael Schmidt, Ph.D., a professor in the Department of Microbiology and Immunology.

The two participated in a virtual TEDxCharleston moderated by The Post and Courier investigative reporter Tony Bartelme. They covered a range of questions about the novel coronavirus, from progress toward a vaccine to doubts about whether there is truly a spike in local cases.

To those who would say the increase in cases is due to an increase in testing, the researchers said: No. The increase is due to the greater spread of the virus throughout our state. That can be seen not just by the increase in “percent positive” tests but by the increase in hospitalizations and the increase measured in sewage. Yes – sewage.

“Stool doesn’t lie,” Schmidt said.

He explained that University of South Carolina environmental health sciences professor Sean Norman has been measuring the amount of COVID-19 that shows up in sewage plants in different areas of South Carolina, and the amount has been going up.

With that increase in mind, they asked people to make wise choices for the greater good when celebrating the Fourth of July. And in speaking about parties and large gatherings, they also explained something called the R0, or basic reproduction number.

The R0, pronounced R-naught, indicates the average number of cases attributable to one infected person. Highly infectious diseases, like measles, have high R0 values. The ideal value for R0 is less than 1, which is akin to stranding the virus on an island – it can’t go anywhere, Schmidt said. Unfortunately, R0 is best calculated in hindsight. Because it can fluctuate depending on human behavior, like wearing masks, scientists can’t pinpoint a real-time R0 value.

What they can say, though, is that if the R0 value is 2, then 15 people attending a backyard barbeque in which one person is infected would spread the disease to 225 people. If the R0 value is 2.5, then that 15-person barbeque spreads the disease to 871 people.

And while most cases of the disease are mild, there is no guarantee about who will have a mild case.

 

Some have argued that we should allow people to become sick so that we can build herd immunity to the disease – herd immunity being the concept that when a majority of the population has antibodies to a particular disease, then it can’t get a foothold to start an outbreak.

But going for herd immunity is a risky strategy, Nadig said. A high percentage of the population would have to develop antibodies.

“That’s a big risk and gamble to take. How many people have to die in the general population to get 80% antibody positive?” he said.

Sweden, for example, decided to take the herd immunity route, yet only 7% of its population shows antibodies, he said.

But the two also noted that there is plenty to be hopeful about. Schmidt said the search for a vaccine is happening at warp speed. In addition, treatments have improved.

“It's medicine – the practice of medicine and the sharing of that knowledge. The evidence has reduced that fatality rate. We know much more than we did in March,” Schmidt said.

While the world waits for a vaccine, some scientists have suggested that giving everyone the polio vaccine – which is plentiful, inexpensive and safe – would jumpstart an immune response to the novel coronavirus. There is some evidence that live attenuated vaccines can improve responses even to diseases they don’t specifically target, Nadig explained. Some think this could be why children seem to be less affected by this disease – because they have recently received the measles, mumps and rubella vaccine, he said.

In closing, the scientists asked everyone to remember to wear masks, wash hands and keep physical distance between themselves and others outside their households. Nadig also asked people to consider donating blood, as hospitals continue to need blood for lifesaving procedures.

And finally, Schmidt urged optimism.

“Remember to be hopeful because there are a lot of folks out there, on planet Earth, working day and night, diligently, to find solutions.”

The session can be viewed on TEDxCharleston's Facebook page.