April 15, 2020: Public Health Update

I trust this note finds everyone in good health. I write today with another public health update on the coronavirus pandemic.

Since my last update, the CDC has announced that there will be antibody testing available within the next few weeks, which will measure two antibodies: Immunoglobulin M (IgM) and Immunoglobulin G (IgG).

Let me offer a quick Immunology 101 lesson: When we are exposed to an illness, our body produces IgM to fight it. During our recovery period, we produce IgG, which in many instances (but not all) gives us lifetime protection against the illness.  If a person is IgM negative and IgG positive, this suggests they had the disease and are now recovered with hopefully long-term protection.  If one is IgM positive and IgG negative, this suggests that they have the active disease and have not yet produced the protective antibody. If one is IgG and IgM negative, this suggests they have never been exposed to the disease or are incapable of producing antibodies. If one is both IgG and IgM positive, they may be early in the recovery phase or one of the tests is a false positive. What does all this mean? In theory, from a societal point of view, if one is IgM negative and IgG positive for COVID-19, they may be able to return to work without fear of contracting COVID-19. If one is IgG negative, they remain at risk for contracting COVID-19 and need to avoid exposure.

While this testing offers important information for the eventual re-opening of society and return to “business as usual,” there are still many critical questions left to answer. What are the sensitivity and specificity of these tests? In other words, what is the chance of getting a false positive or negative? Does a positive IgG correlate with lifetime immunity (as we see in chicken pox, measles, mumps, etc.) or will we be at risk for reinfection (such as influenza or strep throat)? When a vaccine is available and is given to those who are IgG negative, how long will it take after the injection for the full effect? And what is the percent of people who will be fully protected from the vaccine?

Fortunately, we have many bright scientists working to answer all these questions.  In many cases, it is a matter of time.

On another note, I had the pleasure of speaking with Father Bill Wallace, Wesleyan’s Catholic chaplain, last week.  He reminded me that the Office of Religious and Spiritual Life (OSRL) is a wonderful resource to help our students who are dealing with the stressors of isolation, fear of contracting COVID-19, and the major and abrupt changes in routine we are all experiencing.  Our emotional, behavioral, and spiritual well-being is certainly being put to the test. We are lucky to have both the OSRL and Counseling and Psychological Services (CAPS) here on campus.  Contact information for all the University’s chaplains can be found here, while CAPS can be reached at counseling@wesleyan.edu or (860) 685-2910. Faculty and staff may contact the Employee Assistance Program at (800) 854-1446.

I would be remiss if I didn’t continue to stress the principles of physical distancing.  Presently this is our best (if not our only) option to ‘’flatten the curve’’ and this appears to be happening.  We cannot let our guard down now. It’s important for everyone to follow these steps:

a)      Wear a face covering when in public. This is to decrease the risk of spreading COVID-19 as infected people can be asymptomatic for two days prior to symptoms or may be completely asymptomatic.

b)      Maintain a distance of 6 feet (2 meters) from others.

c)      Do not meet in groups of over five people.

d)     Wash hands frequently.

e)     Do not touch your face. Be especially cognizant when donning or doffing your masks.

g)      Cough into the crook of your arm.

h)      Avoid people who are ill.

i)       Wipe down frequently touched surfaces, such as door knobs.

We will continue to forge ahead caring for ourselves and others while maintaining appropriate distancing. We are in this together and will take each day as it comes.

Stay well, be safe, be kind,

Tom McLarney, MD