Masks Not Going Away Yet

Protective masks such as the one worn here by Dr. Daniel Lewis, shown as wife Jessica drives him home some days ago after his release from hospitalization for COVID-19 (which he now tests out as no longer having) are likely to remain commonplace for a long time to come, Lewis predicts. Such protection not only helps deter spread of the coronavirus, but also more commonplace viruses such as those causing colds and flu.

Dr. Daniel Lewis, chief medical officer for Greeneville Community Hospital, practicing physician and COVID-19 survivor, believes that a vaccine against the virus will be developed … but probably it will take some time.

In a Greeneville Sun interview this week with the local physician, who practices family medicine and sports medicine with Ballad Health Medical Associates, Lewis commented on several matters that are now part of an international conversation about COVID-19.

Asked if a COVID-19 vaccine might prove as elusive as a vaccine against HIV has been (no such vaccine yet exists after decades of effort) Lewis expressed tempered optimism.

“There are different types of viruses in regards to genetic material. Coronavirus is an RNA virus, and we have successfully developed these (vaccines) in the past, and they are generally safer and more efficacious,” he said. “While HIV also is an RNA virus, the body’s response to this infection is totally different than most infections, hence a lack of immune response for HIV vaccine attempts.”

For coronaviruses, though, a “vehicle for carrying coronaviruses” already exists, he said. “I think these efforts will be successful, but will probably require several months to a year to develop and fully test.”

Asked about the current pace of “reopening” businesses and economic activity in light of the likelihood of COVID-19 lingering for weeks or months longer, he replied, “I understand the importance of reopening local businesses, and I think that it is appropriate. I feel like the proper steps and timing are being recommended for restaurants, etc. I do think that wearing a mask is appropriate … wearing a mask and proper hand hygiene are the best steps we can take to prevent the spread of COVID.”

He added, “It is thought that, if 80 percent of the population would wear a cloth mask, which is thought to be 60 percent effective, we can reduce the transmission of COVID to less than one case of spread per infected person, and the virus will burn out. When I’ve been out, however, typically less than half of the people I see are wearing a mask.”

Lewis suspects a “new normal” that includes masks, distancing and hygienic practices is going to endure for a good while, “at least until we have a widely available vaccine.”

Even after that, he hopes to see practices such as pre-disinfection of shopping carts and regular hand-washing to continue, as these can help deter other diseases such as colds and flu along with COVID-19.

It even is possible that masks could become prevalent in a lasting way, as they have in China due to other diseases.

“I do think we will continue with some modifications of our routine activities or quite a while, if not permanently,” he said.

Does he consider himself now immune from COVID-19?

“I have had an antibody test that shows I have antibodies against coronavirus; I don’t have specifics about the validity of the test, as it was a trial I participated in, and there is some concern about cross-reactivity with antibodies against the more common coronaviruses (four of which are known to cause URI and colds),” he said. “The other coronaviruses present at least a transient degree of immunity. Most of the reported cases of ‘re-infection’ seem to be secondary to sampling error or inexact testing.”

He continued: “My belief is I have some degree of immunity, which I hope is permanent, and I do believe we can and will develop a ‘herd immunity’ over time. However, given its ‘newness,’ this will take months to develop, and the exact costs in terms of death, etc., are unknown.”

Lewis is limiting his work hours and spending time building up muscle he lost during his hospitalization. He estimated that his strength level diminished upwards of 30 percent.

He sees the experience of dealing with the pandemic as probably being good, in some ways, for local and regional health care systems.

Ballad Health’s response to the coronavirus situation has been “robust and stronger” than might have been the case with “two competing health care systems in the region as we previously had.”

Rebounding for Ballad, though, will have some challenges, he said. “I do think that Ballad, like many other health care systems, will face some short-term challenges, given the expense and loss in revenue that comes with limiting surgery, etc.” but ultimately “we will come through this situation stronger and more capable.”

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