Doctor weighs in on what it will take to get back to normalcy

Coronavirus
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CHICAGO — What will it take to get back to life as we know it? Here are projections and models, charts and graphs. And on both sides of the peak – progress. Now, an infectious disease doctor on the frontlines weigh in.

“I think the most important public health message even though it seems we may have hit our peak in Illinois and Chicago and there are brighter days ahead we still have a lot of time ahead of us,” Dr. Larry Kociolek, Lurie Children’s Hospital infectious disease specialist, said.

And what we do and how we behave during that time will be critical.

“So I think going from where we are now to completely lifting all restrictions and loosening all public health measures will be a mistake,” he said.

That’s because there are natural risks associated with lifting social distancing practices.

“By doing social distancing we’ve reduced the number of deaths significantly,” he said. “We’ve reduced the number of infections but the consequence of that is there are a whole lot of people in the population that haven’t yet been exposed so if exposure and infection protects you from future infection there will be more individually in the community that are susceptible and any reintroduction of coronavirus in the community could result in a resurgence even sooner than the fall and winter resurgence that is predicted.”

Looking toward summer, our city’s busiest season when it comes to tourism as our curve flattens, other states, particularly in the south, will continue to see high coronavirus activity.

“As we know, Chicago is a notorious hotspot in the summer so it’s very possible that even though we as a community have suppressed virus activity significantly through public health measures if there is a lot of travel to Chicago from complete lifting of the public health measures it’s possible to reintroduce that into the community,” Kociolek said.

While public health officials monitor summer tourist traffic, they’ll keep an eye on activity in the southern hemisphere — parts of the globe that each year provide a glimpse of what’s to come in terms of the annual flu. This year, doctors will add COVID-19 to their down-under watch list.

“I’m eager to learn about what happens in the southern hemisphere as they approach their winter months and how activity spreads there that’s oftentimes how we can gauge our upcoming flu season based on what’s happening in other parts of the world,” Kociolek said.

For the United States and the entire world, serology – or anti-body testing – will play a critical role in assessing immunity and what, if any, protection a previous infection might provide. The test is in development with some already commercially available.

“Serology testing tests the blood to see if the immune system has seen coronavirus before,” Kociolek said. “Time will tell whether or not a previous coronavirus infection completely protects you against a future infection or will make a future infection much more mild and less risky from having a severe complication or if those antibodies are protective at all it’s not something we yet understand about this virus.”

The end game is a vaccine for all to permanently keep the virus out of the human population. Kociolek says distribution would be tiered and given to those at highest risk first — that includes healthcare workers, the elderly, people with chronic heart and lung disease and patients who are immuno-compromised.

“Ultimately to eliminate a infectious disease threat from the community you would need very high vaccine coverage which means a substantial proportion of the population that are protected with a vaccine,” Kociolek said.

Even when we do return to work and resume our daily lives, Kociolek says our world may not look or act the same.

“Even if we are going back to work for example resp etiquette and hand hygiene are going to be very very important and it’s going to be essential for public health officials to continue to perform surveillance of COVID-19 in our population to identify early signs of a resurgence and reactivate social distancing and public health measures quickly if that occurs,” he said.

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