President Donald Trump last Friday described the decision of when and how to reopen the country from the current coronavirus-based shutdown as the most difficult one he must make. The president is correct; the decision has several unknown consequences yet to be discovered.
In this context, it will be critically important for President Trump to consider the following points before reopening the U.S. economy at normal levels again.
—The decision to employ a stay-at-home approach in several states has likely diminished the ability of many people to develop an effective level of adaptive immunity against the virus. Therefore, becoming infected with the virus after the reopening could carry a higher risk of death among these individuals, if they also carry certain underlying conditions.
—The solution to this problem is not confining people for longer periods. Staying at home will not give them any addtional or improved immunity. Why? Human beings need regular exposure to small viral loads for several weeks to develop immunity.
—Accordingly, and because the unfounded decision by several governors to force otherwise healthy people to stay home has occurred already, and will definitely reduce people’s ability to resist the virus if they are exposed to it, it's now imperative to prepare for further possible outbreaks in the near future.
—It's also important to mention that any increase in the death rates due to the coronavirus will likely be used politically to undermine President Trump in the next election; despite the fact that he was not the one who ordered healthy people to quarantine themselves or prevented them from developing gradual immunity.
The president my need to clarify this point to America.
—The president and his team need to consider the necessity of making hydroxychloroquine and azithromycin available in every hospital, pharmacy, and urgent care facility in the U.S. prior to reopening the country.
This would allow for early treatment of COVID-19 infected patients.
Such early intervention with an equally promising therapy may cure many patients, thus dimishing the spread of the virus. Additionally, early use of the recently FDA-approved treatment can — at least theoretically — diminish the load on hospitals and probably decrease the death rates; late intervention could be useless if the virus causes significant damage and fibrosis to lungs.
The latter situation could render hydroxychloroquine/azithromycin therapy ineffective, thereby significantly affecting the results of clinical trials and also falsely indicating the therapy as ineffective. The country cannot afford this outcome, given the success so many doctors have achieved using the medications to treat COVID-19 patients.
—Granted, the stay-at-home approach was basically meant to flatten the curve of new cases while lessening the load on hospitals until the country could set up emergency beds and manufacture more ventilators.
Those two goals have been accomplished
However, the use of ventilators to treat COVID-19 lung infections has shown serious deficiencies, so the rationale of stay-at-home orders is no longer justified.
—Relying predominantly on the test to detect the presence of COVID-19 immunity (IgG) in the blood allowing people to return to work needs further consideration. At this time, the test is showing approximately 30% false results. What are we going to tell people if they show negative results for the antibodies (i.e. they are not immune to the virus)? Shall we tell them to stay home for another year until a possible vaccine develops? Or, should we allow them to return to work but be prepared to be treated with the hydroxychloroquine/azithromycin combo if they begin to show symptoms?
—Because chloroquine has a low therapeutic Index — in other words, the difference between its therapeutic dose and toxic dose is small — it's critical to provide the best possible education to both doctors, nurses, pharmacists, and patients to minimize risks of toxicity and serious drug interactions associated with chloroquine’s use.
Despite these uncertainties and misgivings, I trust President Trump to exercise wisdom in making such a complex and delicate decision.
Dr. Tawfik Hamid (aka Tarek Abdelhamid) M.D.; Mlitt (Edu) has testified before Congress and before the European Parliament. Dr. Hamid is the author of "Inside Jihad: How Radical Islam Works, Why It Should Terrify Us, How to Defeat It." Read more reports from Tawfik Hamid — Click Here Now.
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