We continue sharing expert responses to your top incoming questions.
Note these responses are not intended to be medical advice, for that—as always—you must consult your own personal physician. (View Part 1, Part 2 and Part 3)
1. What’s the likelihood that a person, who had COVID-19 and recovered, will be re-infected with coronavirus again?
Because the coronavirus is new, researchers cannot say for certain that an initial infection guarantees lasting protection. But based on the experience with other viruses, including other coronaviruses, they expect that people who recover will be shielded for perhaps at least a year or two, and from there the immunity might start to wane (but not disappear). Evidence suggests they would also be less likely to pass the virus on to others.
2. I’m at home all the time, and my blood-sugar levels are all over the place. Help!
Many things affect blood-glucose levels: stress, physical activity, sleep, eating and more. If your blood-sugar levels are, understandably, not as consistent as they have been, consider the changes to your daily routine and how they make be throwing a wrench in your T1D management.
For example, are you getting up at the same time? Are you getting the same amount of physical activity? Are you considerably more stressed than you were before? Has your diet changed? These are all factors that contribute to blood-sugar levels.
As much as possible, strive for a normal lifestyle—even under quarantine. Try to get exercise, eat healthily and get sleep. If you do need to adjust basal rates, insulin to carb ratios and more, contact your physician.
3. I’m going crazy not having a gym to go to. What are the exercises to do at home?
“My blood sugars have been higher than I normally like,” says Sarah Tackett, who’s had T1D since 2013, and is under quarantine. “I’ve made some really minor changes to my routine over the last few weeks to try to stabilize my blood sugar as much as possible. Here are some baby steps I’ve taken that are making a difference for me.” One of these is exercise. Go here for her recommendations.
You can also visit the Breakthrough T1D exercise page to learn how to exercise safely and successfully with T1D. There are also a ton of studios that are generously providing free classes (or long free trials). You can see the classes here.
4. There is the potential for a vaccine, like the flu shot, in the next year. Where are we on that front?
According to the World Health Organization, that are 60+ efforts currently underway to make coronavirus vaccines, and there are three potential vaccines in clinical trials now, developed by:
- CanSino Biological / Beijing Institute of Biotechnology
- Moderna / National Institute of Allergy and Infectious Diseases
- Inovio Pharmaceuticals
Initial tests in a clinical trial focus on safety, and researchers in China and the United States are trying out different doses of different types of shots. NIH infectious disease chief Anthony Fauci, M.D., said there are “no red flags” so far and he hoped the next, larger phase of testing could begin around June. Still, the vaccine may take 12 to 18 months, if not more, to be available to the public.
5. What is antibody testing?
Antibodies are molecules made by the immune system in response to virus, which have a unique signature. Usually it takes more than a week to develop a robust antibody response, but they persist in the blood. Blood samples can tell if you have antibodies to COVID-19, meaning that you have had contact with it. (The main diagnostic tests for COVID-19 involve nasal or throat swabs and a technique called PCR. Upon recovery, however, the body overcomes the virus, and it isn’t found with this technique.) The antibody tests can detect those who have recovered from the infection—be it those who were asymptomatic or had minor symptoms, and those who were infected but never got tested—and could also answer outstanding questions about the spread, reveal the true scope of the pandemic and calculate a better estimate for the mortality rate of COVID-19. At a community level, blood tests could point to more people being immune than realized, which could signal that future waves of coronavirus cases might be less intense than some forecasts anticipate.
Academic institutions and companies have already started to offer antibody tests, but, even among those that have been validated, they can still provide false results.
6. Can people go back to work if they are antibody-positive?
Yes and no. An accurate antibody-positive test could mean that an individual can safely go back to work, but the virus is so new that researchers cannot say for sure what will signal immunity or how long that armor will last.
7. What is “herd immunity”?
Herd immunity is what happens when enough members of a population have antibodies to a contagious disease. That means the virus can no longer spread easily from one person to another. For COVID-19, to get to herd immunity, the percentage of the population who has immunity would need to be between 40 and 95 percent, depending upon COVID-19’s transmission rate, which we don’t yet know.
8. What is this I hear about clinical trials involving plasma to treat current coronavirus patients?
Convalescent plasma is an antibody-rich product made from blood donated by people who have recovered from the disease caused by the coronavirus. Prior experience with respiratory viruses and limited data that have emerged from China suggest that convalescent plasma has the potential to lessen the severity or shorten the length of illness caused by COVID-19. It’s hoped that injecting patients with these antibodies might provide an initial layer of protection as their own immune system kicks into gear.
The FDA has announced national efforts to facilitate the development of and access to convalescent plasma. There are a number of clinical trials under way to evaluate the safety and efficacy of convalescent plasma, and the FDA encourages those who have recovered from COVID-19 to donate plasma to help others fight this disease.
9. Drugs, some FDA-approved and some not, are now being tested to see if they work for coronavirus. Do they hold promise?
A number of drugs have been repurposed for the potential treatment of COVID-19, including:
- Hydroxychloroquine, which can treat malaria and is used as a secondary treatment for lupus and rheumatoid arthritis
- Remdesivir, an experimental drug that has worked against other coronaviruses, that is given intravenously and could prevent infection and reduce the severity of symptoms when given early enough in the course of illness
- Inhaled nitric oxide, an FDA-approved drug known to relax blood vessels, for use in patients with severely damaged lungs
- Bacillus Calmette-Guérin (BCG), which is used as a tuberculosis vaccine (but not, however, in the United States) (The World Health Organization (WHO) published a scientific brief examining BCG, and concludes that there is no evidence that BCG protects people against infection with COVID-19. There are two clinical trials of BCG underway for COVID-19, and the WHO will evaluate the evidence once it is available.)
We don’t know if they hold promise, but there are or should be soon clinical trials that will show soon whether they are warranted for further study.
10. What is a virus, and how are they different than bacteria?
Bacteria are living cells that can survive and reproduce on their own. Viruses, however, are not alive. Each virus consists of a piece of DNA or RNA (the COVID-19 is made of RNA, which evolve faster than those with DNA), encased in a protein (sometimes surrounded by fat membrane). It reproduces only by co-opting the cellular machinery of its host, turning it into a virus factory. The strategies used against bacterial diseases—antibiotics—do not work against viruses. Also, viruses tend to mutate quickly, and readily acquire drug resistance.
