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Reader Q&A: Is this a ‘second wave’? Has COVID-19 mutated? What have we learned in 8 months?

A spike in cases has residents asking new questions about the coronavirus

A recent spike in COVID-19 cases in Southwest Colorado and northwest New Mexico has prompted public health officials to issue stricter guidelines in hopes of limiting the virus’ spread.

The uptick has also led to new questions about the novel coronavirus, including whether we are experiencing a “second wave,” how the virus has mutated and what we have learned in the past eight months that might help with the latest response.

Here are some of the questions we’ve heard from readers, and the answers:

How do public health officials explain the most recent spike in COVID-19 cases in La Plata County?

With cases on the rise, there’s no one single cause driving it. Instead, it’s a variety of factors, said Brian Devine with San Juan Basin Public Health.

It’s getting colder out, so more people are spending time indoors, where it’s easier to catch the virus. Positive cases have been traced to Halloween parties, people watching sports with friends, hanging out at bars and restaurants (especially late at night and socializing with strangers) and friend groups not taking precautions while hanging out.

Is the recent spike a “second wave”?

Public health officials say there is no standard definition of a “wave” when it comes to epidemic diseases, Devine said.

Instead, many scientists, including Dr. Anthony Fauci with the National Institute of Allergy and Infectious Disease, think of all of 2020 as the “first wave” of infections, with peaks and valleys within that wave, Devine said, because the U.S. never truly got infections under control in either the spring or summer.

What’s the latest thinking about when a vaccine might be available locally? Who will receive it first?

In an email to The Durango Herald, San Juan Basin Public Health spokeswoman Claire Ninde said the health department is prepared to receive vaccines, but doesn’t expect them to arrive until December or January. Based on the number of vaccines estimated in the first shipment, Ninde guessed Colorado would receive 300 to 400 doses total. Those doses are expected to be administered first to health care workers, first responders and long-term care facility workers.

What would it take for another stay-at-home order in La Plata County?

La Plata County is at a Level Orange designation, which went into effect Friday. Level Orange is a high-risk designation and is labeled “safer at home.” There are three main metrics that would signal to the health department the designation should change to Level Red, a stay-at-home order: active infections over 350 per 100,000 residents, a greater-than 15% positivity rate and increasing hospitalizations.

If a county is over any of those three thresholds for a two-week period, the health department will consult with the Colorado Department of Public Health and Environment. Those two weeks are a grace period and if the county is able to control the spread in that time frame, no further action is needed.

If after the two-week period, infections are still over the threshold numbers, the health department will further consult with CDPHE about next steps. La Plata County had over 350 active infections per 100,000 citizens on Nov. 8, Ninde said.

Has the virus mutated and become less deadly than it was in March?

Yes, the coronavirus mutates, but whether it is becoming less lethal is harder to say.

Mutations seem to help the virus spread more easily. They don’t seem to cause more severe cases of COVID-19, current research indicates. That’s the case for a mutation in the virus’ spike protein, which first emerged in Europe, according to Houston Methodist research published in October. The strain has become the most common in the world, yet COVID-19 death rates are lower worldwide, according to news reports. Experts disagree about why or how long that will last. Aside from the virus, factors like data collection early in the pandemic and medical care capacity can also affect death rates.

But health professionals are keeping a close eye on mutations because they can impact transmission rates, effectiveness of treatments and severity of the disease. Each new infection is a chance to develop more dangerous mutations – and the virus has a lot of chances in the global population, according Houston Methodist researchers.

What do we know about immunity? Is it possible or likely to catch the virus more than once?

There’s a lot we still do not understand about immunity. Some reports have indicated that people who were diagnosed with COVID-19 have gotten it a second time, according to the Centers for Disease Control and Prevention.

Based on other viruses, including common human coronaviruses, some reinfections are expected. Researchers are trying to understand the frequency and severity of reinfection and high-risk populations for reinfection. The novel coronavirus that causes COVID-19 is called SARS-CoV-2.

“These reports can understandably cause concern,” the CDC website said. “The immune response, including duration of immunity, to SARS-CoV-2 infection is not yet understood.”

What do we know now that we didn’t know eight months ago about the virus?

At first, health experts were not sure if the virus could be carried in small droplets called aerosols.

Experts knew the coronavirus could spread through larger respiratory droplets from the beginning. Now, the World Health Organization and the Centers for Disease Control and Prevention have both said the virus can be spread through airborne transmission as well.

For the WHO, the shift primarily occurred after hundreds of scientists from almost 40 countries wrote an open letter with evidence showing that the virus could hang in the air or house, making stagnant indoor air more risky, according to Yale Medicine.

Initially, experts were not certain how long the virus would linger on surfaces.

The CDC lists surface transmission as less common than through sneezes, coughs and asymptomatic people. Still, scientists have found that SARS-CoV-2 is detectable in aerosols for up to three hours, copper up to four hours, cardboard up to 24 hours, and plastic and stainless steel up to two to three days, according to Yale Medicine.

Experts were not sure about transmission via household pets.

COVID-19 cases have been reported in dogs, cats and even tigers. Fortunately, those animals seem to have mild symptoms.

But several European countries have reported a unique mutation of the coronavirus transmitted between humans and mink. Some experts are concerned about what the strain means for the effectiveness of treatments. The implications of the identified changes in this variant are not yet well understood, according to the WHO.

Do you have a specific question about COVID-19? You can submit them by emailing herald@durangoherald.com, and we’ll try to answer your question in a future story.

Nov 17, 2020
With COVID-19 cases spiking, La Plata County to enter ‘Level Red’ regulations Friday
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