24/3/2020

South Padre Island is blessed to have two of the world’s leading virus hunters living right on our island. Island Matterstapped into the expertise of Dr. Susan Fisher-Hoch and Dr. Joe McCormick to get a deeper insight to what is going on in the world. They generously gave us a few minutes of their time, between full days of Zoom video conferences.

"There needs to be coherence. Right now, coherence is limited,” says Dr. Fisher-Hoch who is self-quarantining with her husband Dr. McCormick in their South Padre Island condo. Dr. Fisher-Hoch and Dr. McCormick are Texas epidemiologists who served on the front lines during the first Ebola outbreak and are co-authors to the book "Level 4: Virus Hunters of the CDC."

Like many South Padre Islanders, they have a second home in a similar small community in Colorado frequented by many tourists. The Colorado resort is where the epidemic had gained momentum. Introduced in February by international and east-coast skiers, the virus spread like wildfire to the community and beyond. Their one small hospital is being overwhelmed.

"Given that scenario", says Dr. Fisher-Hoch, "the same can happen on the island, since we also rely on tourists. Given our limited size and resources, we must close everything we can, except food stores and pharmacies; probably also the beach except for individuals or couples walking. In much worsening circumstances, we might even consider quarantining the island, (but) we are not there yet.”

COVID-19 is caused by a coronavirus. There are hundreds of coronaviruses across all sorts of species from snakes to whales to all sorts of mammals. They live in balance with their natural hosts, but if they ‘species jump’ this balance is overturned. We have already had two coronavirus introductions to humans this century, first SARS and then MERS. The first likely from bats and the second from camels.

These were more severe diseases with few asymptomatic infections, so it was easy to spot infected people quickly and isolate them. They were also more difficult to transmit human to human. COVID-19 transmits with great ease. It frequently is spread by asymptomatic people who then spread it to others. For every person infected, it will spread to 2 to 3 more. This is why our own behavior is our best protection

Right now, the public has either gone into a panic - and bought up all the toilet paper - while others say it is overblown. There is also extensive misinformation on the web, and a significant number of people are sourcing wild and inaccurate information. There has been speculation over whether it is as bad as any of the other outbreaks such as seasonal influenza. Medically, it can only be compared to the 1918 influenza outbreak.

Drs. Fisher-Hoch and McCormick described the difference between disease outbreaks of the past starting with their specialty, Ebola. "Ebola transmits with difficulty, you need body fluids, contact with blood, scratches, vomit, or something on you. We don’t have that environment here.

“We live far too well to spread Ebola. Ebola is spread in very poor crowded circumstance. This is expected in poor areas of Africa because of living conditions." She said that H1N1 in 2009 was a milder disease for which there was some immunity. That is not the case for COVID-19. Everyone is susceptible to COVID-19 because our immune systems have never seen it before.

As lifelong virus hunters, Drs. Fisher-Hoch and McCormick advise that "the best thing to do with people is tell them the truth." She noted at the time they are trying to stay positive by self-isolating, but she must be realistic. “This is serious, and SPI residents are strongly advised to consider self-isolation—particularly the most vulnerable to severe even fatal disease (people over 60, those with underlying conditions such as diabetes, or autoimmune conditions or cancer). Liberally use Lysol or sanitizer wipes, hand washing, paying attention to doorknobs, and whatever you are touching outside your home. All the usual advice from many sources.

“Our biggest problem is the disaster with the testing kits. If we knew where the virus was at any given time, we (could) focus our efforts where it is circulating. Identifying and tracking (e.g. GPS) people with infections and quarantining them would also enable the ability to provide direct advice to residents most at risk.” One rule she gives is, "Don’t go to the emergency room, because if you did not have something, you'll leave with something."

Dr. Fisher-Hoch also urges more use of telemedicine. Call lines to ask for advice are being created. “It's always better to keep the populous informed on the real risks, otherwise the hospitals/clinics are going become overwhelmed. Hope won’t do anything for us except make us feel better, we all need to act."

Ultimately, it is up to the community to police itself, because this is going to go on for a long time. If it is not handled with care, we risk another flare-up later. For the sake of self-preservation, including businesses, taking the stringent measures needed now will help avoid the worst that could come quite quickly later.