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By Robert Lehman, M.D., Post 3063 Surgeon

As a physician, public health officer, and member of this organization, I offer this brief update of where we are with COVID-19.

There are 7 corona virus strains that affect humans.  Four of them we have all experienced, as 25% of the common cold is a corona virus.  In 2003, SARS (Severe Acute Respiratory Syndrome) killed 800 people in China and 3 other countries.  With very tight isolation and wearing masks, and with the luck that the virus was less contagious than the flu, the disease was controlled, and disappeared before a vaccine could be created.  In 2012, MERS (Middle East Respiratory Syndrome) affected 27 countries, primarily in the Middle East.  Although 900 people have died from this, (one-third of those infected), it has not easily been passed from human to human.  And now we have SARS-CoV-2, the virus causing the disease COVID-19.

This virus is rapidly spread because 40% of those infected NEVER have symptoms, and thus continue to infect others, often for weeks.  This is a respiratory virus spread by an infected person when breathing out.  That is why EVERYONE needs to wear a mask when around others, as the person without symptoms does not know they are infected and thus can infect others.  It is breathing that infects others, and that is why it is vital that the NOSE and MOUTH be covered.  Face shields are NOT approved as there is no filtering when that person exhales, and bandanas have been shown to be worthless.

To emphasize this, masks are primarily worn to protect OTHERS; although there might be a small amount of protection to the person wearing the mask.  [Wearing a mask should remind people to wash their hands whenever they remove their mask, before they touch their face.].  People who stand out at rallies without masks and say “if I die, I die” don’t understand this.  They need to wear a mask as they can never tell if they themselves are infected and thus passing it to others.  It isn’t their lives at risk when they don’t wear a mask; they pose a risk to the rest of us.

This has been a confusing virus as 40% of people infected have no symptoms, and yet others become extremely ill and die.  I’ll skip the long scientific explanation, but a protein named ACE2 might be a key.  It appears that ACE2 receptor is a magnet for the virus.  Those with higher levels of ACE2 might get ill easier and far more severe than someone with a low level.  ACE2 is higher in chronic lung and heart diseases, diabetes, obesity, smokers, and pregnancy.  Genetically, it is higher in some families than others.  It does appear that it tends to be less in children.

Lastly, the world seems to be putting its hope on a vaccine.  But to use the annual flu vaccine as an example, flu vaccine is recommended to prevent people from DYING from the flu.  As we all know, some people will continue to get the flu despite having been vaccinated.  I hope that I am wrong, but I doubt a SARS-CoV-2 vaccine will prevent all cases of COVID, but hopefully it will dramatically decrease deaths and the need for hospitalization.

In the meantime, please wear your mask whenever around others to prevent infecting others if you happen to be one of those infected and without symptoms (and who may continue to shed the virus for 14 days or more).  AND, wear a mask to also remind yourself that your hands might be contaminated and might infect yourself.  ALWAYS wash your hands or use sanitizer whenever you remove your mask, particularly for eating, drinking, and smoking.