Expert advice on protecting yourself as COVID variants loom

The increasing availability of vaccines and a recent drop in the number of COVID-19 cases shouldn’t distract us from the fact that we’re in the thick of a pandemic with a virus that is mutating and able to spread more easily. That’s according to infectious disease specialist Krutika Kuppalli, M.D.

“If we don’t get the virus under control, more variants could emerge. We really need to double down on our public health measures,” she said.

 

Kuppalli, a nationally recognized expert and an assistant professor in the College of Medicine at the Medical University of South Carolina, said she’s bewildered by people who are going about their lives as if the virus isn’t a big deal. “We’re seeing no outrage over the number of deaths that are occurring. It’s very perplexing to me how people are acting.”

Kuppalli is concerned about the impact of the variants that have emerged so far. The three that are best known were first detected in the United Kingdom, South Africa and Brazil. All three have since shown up in the United States.

The variant that cropped up in the U.K. last fall, B.1.1.7, became the dominant strain of the coronavirus there in about three months. And it didn’t waste much time in crossing the pond. “It's been identified in a number of states here in the United States, including one case here in South Carolina over the weekend. That is obviously concerning,” Kuppalli said.

The variant first identified in South Africa, B.1.351, emerged around the same time as the one in the U.K. It’s a world traveler, too, showing up in South Carolina and at least one other state so far. “The biggest issue we're concerned about with this variant is that it may affect the levels of neutralizing antibodies from both the Pfizer and Moderna vaccines,” Kuppalli said. Both companies are developing booster doses. Another concern: B.1.351 may be able to reinfect people who have recovered from COVID-19.

The variant first detected in people from Brazil, P.1, showed up in December and is blamed for causing a huge surge in the city of Manaus. And worryingly, like B.1.351, P.1 may be able reinfect people who have already had COVID-19.

Kuppalli said health experts and the public need to factor all of that into their plans as the pandemic continues. “We need to learn lessons from what has happened with these variants in other countries to try and prevent those situations from happening here.”

Pandemic Precautions

The good news is that there are plenty of steps people can take to try to stay safe. We’re all familiar with physical distancing, hand washing and avoiding crowds and poorly ventilated places.

But what about masks? Are the ones you’ve been using good enough? The Centers for Disease Control and Prevention recommends using masks with two or more layers of washable fabric you can breathe through. Make sure they completely cover your nose and mouth and fit snugly without gaps on the side of your face.

Michael Schmidt, Ph.D., a nationally known microbiologist, immunologist and professor in the College of Medicine at MUSC, said masks can work. The fact that almost nobody is getting the flu in South Carolina, thanks to mask wearing, shows how effective the face coverings can be. 

But they aren’t foolproof. The coronavirus is much more easily spread than the flu, he said. 

That’s why some people are trying new approaches such as double masking. “One will contain a substantial fraction of the virus that you're shedding. Mask two will catch the stragglers that are escaping.”

Schmidt has a tip for people who want to try double masking. “You can cheat. You can sneak a second mask into the first mask, cutting the strings off of one of them. So you have another layer without the added burden of contending with two sets of strings.”

 

That can work with both medical surgical masks and with N95s. “N95s only exclude 95% of liquid and airborne particles. Five percent always leak through. If you add another mask, you up your protection.”

But Schmidt said N95s can be pretty uncomfortable. “The N95 mask is extremely taxing to wear because you have to move air across the pressure differential. So it's not pleasant to wear.”

That’s part of the reason Schmidt personally uses copper masks. The other part: He’s known for studying and showcasing that metal’s antimicrobial properties in clinical settings. Now, the coronavirus has given copper a pandemic patina. “We know copper does indeed inactivate SARS-CoV-2, and it does it very quickly.”

If you’re considering using a copper mask, Schmidt suggests making sure you choose one that has undergone scientific scrutiny. You can use his double-up trick with the copper mask, too, cutting the strings off a surgical mask and putting it inside the copper mask for extra protection.

Whatever type of mask you choose, Schmidt said make sure you wear it. “They need to be wearing masks when they're out in public, irrespective of whether they think coronavirus is real or not, because we're not infringing on your civil rights, we're protecting you and your loved ones. And you're helping us protect my loved ones.”

Kuppalli agreed. “We know the variants to have increased ability to transmit. We want to prevent that from happening because increased transmissions lead to increased hospitalizations and potentially increased death. South Carolina right now is not doing so great with coronavirus. Cases are going down a bit, but compared to rest of the country, we still are toward the top.”