As businesses and recreation areas continue to reopen since the coronavirus shutdown in March, some people may believe the threat of the SARS-CoV-2 virus that produces the disease COVID-19 is behind us, but the fact is cases are spiking. What was true regarding taking precautions 3.5 months ago still stands today. In fact, there has been a surge of new cases in the nation and in San Diego County, making it more important than ever to be safe.
Nationwide, a single-day case record was set on July 1, with more than 48,400 new positive coronavirus tests recorded on that one day. In San Diego County, to date there have been more than 15,000 cases of COVID-19, including the 497 new positives reported on June 29, a single-day record. The previous record was set just the day before. There have been 365 deaths in San Diego County due to COVID-19 and a whopping 3,400 in Los Angeles County.
The United States still leads the world in reported infections (2.68 million) and death toll numbers (128,000). In California, about 244,000 cases have been tallied, with nearly 6,000 deaths.
Precautions: A Review
There are ways to reduce the risk of getting COVID-19. On July 1, the County updated its Order of the Health Officer and Emergency Regulations that can be found here. Reducing the risk of exposure and illness includes the following:
- Staying home: The fact that restaurants, the zoo, and hair salons have reopened does not mean these places are infection free. It is still best to stay at home and limit out-of-residence exposure except for essential needs, to go to work, or to participate in outdoor activities as a household.
- Wearing a mask: A face mask worn over the nose and mouth can cut down on the spread of SARS-CoV-2 by creating a barrier to trap potentially infectious droplets when someone coughs or sneezes. Masks not only protect the wearer but others too, and they are required in San Diego County for anyone two years and up.
- Social distancing: Keeping a distance of six feet or more between people not in the same household can reduce the chance of breathing in infected particles. The practice of physical distancing while wearing a mask provides even more protection.
- Washing hands: Washing hands often with soap and warm water for at least 20 seconds at a time helps. Use hand sanitizer (with a 70 percent alcohol level) and hand wipes when soap and water are not available. Always wash hands before preparing and eating food and after coughing, sneezing, nose-blowing, touching animals or pets, and using the bathroom. Spraying disinfectant on door handles and knobs can help too, as can wiping down surfaces often.
- Cleaning surfaces: Common surfaces should be cleaned and disinfected between uses. Take special care with handles, knobs, light switches, phones, keyboards, remote controls, and other items that multiple people touch. Wear disposable gloves when using a disinfectant and clean hands after gloves are removed.
Signs and Symptoms of COVID-19
A wide range of symptoms associated with COVID-19 has been reported. Some people’s symptoms are very mild, while others are severe. People can even have the disease or pass it to others without knowing they have it, which is why staying at home or wearing a mask and social distancing when in public are essential precautions for everyone to take, whether they feel ill or not.
Contact your health-care provider if you experience the following common signs of COVID-19: 
- Fever
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- Loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
Call 911 and seek emergency medical attention if experiencing the following:
- Trouble breathing
- Persistent pain or pressure in the chest
- Confusion
- Inability to wake or to stay awake
- Bluish lips or face
Testing
There are two types of tests available for COVID-19. A viral test will tell if you have a current infection, while an antibody test might tell if you had an infection in the past. Call your health-care provider if you think you need a test.
The County of San Diego offers free testing at various locations. call 211 or go online. You will be directed to testing locations that do not require a referral. Appointments are required, except at the Tubman-Chavez Community Center walk-in site. To make an appointment, go to the San Diego County Testing Sites website and search for appointments by location or by day of the week.
Certain CVS drug stores also offer testing without a referral. Appointments can be made up to three days in advance, but they fill up fast. See the CVSHealth COVID-19 Testing website for more information.
Who Should Get Tested?
The San Diego County website states that people experiencing symptoms of COVID-19 infection have the highest priority for testing. Others who should be tested include:
- Health-care workers, first responders, and other social service employees and people working in essential jobs
- Seniors 65 and older
- People with chronic medical conditions
- People living in a residential or group setting, including shelters and long-term care facilities
- People exposed to infected individuals where risk is high
Vaccine Developments
There is promising news on the vaccine front. Currently, 14 COVID-19 vaccines are in human trials.
The COVID-19 front-runner, Moderna, has finalized the design and dosage of its Phase 3 COVID-19 vaccine. Moderna is moving into late-stage trials with its mRNA-1273 drug and will be testing it on 30,000 subjects this month. The objective of the trial is to assess the drug’s ability to prevent someone from catching and transmitting the SARS-CoV-2 infection and therefore prevent hospitalization. Moderna has signed with Catalent, which will prepare to produce 100 million doses of the vaccine for the U.S. market beginning in the fall of 2020.
On July 1, the drug company Pfizer, in association with the biotech firm BioNTech, reported that its experimental vaccine, also based on messenger RNA technology, has spurred immune responses in healthy patients. Although the vaccine also caused fever and other side effects at high doses in trial candidates, it did generate antibodies against the SARS-CoV-2 virus that results in COVID-19, and some were neutralizing antibodies that can prevent the virus from functioning. The clinical data have not yet been peer-reviewed or published in a journal, and testing will continue.
Inovio Pharmaceuticals on June 30 reported its vaccine, INO-4800, had shown positive results in a small trial. Inovio states that 94 percent of its Phase 1 trial participants demonstrated overall immune responses at week six after receiving two doses. Through week 8, the drug produced no adverse serious side effects. Inovio is to begin a Phase 2/3 efficacy study in the United States this summer.
Blood Type and COVID-19
An interesting correlation between blood type and COVID-19 recently has surfaced: Blood type may be a determinant in who contracts the SARS-CoV-2 virus and how severe the COVID-19 illness will become in patients. As reported in the New England Journal of Medicine in June, researchers studied 1,600 COVID-19-positive patients with respiratory failure and determined that people with blood group O are at a lower risk of acquiring COVID-19 than non-O blood groups, and people in blood group A have a higher risk of acquiring the illness than non-A blood groups. The study participants were among seven hospitals in Italy and Spain, all having severe respiratory illness, and were compared to about 2,000 healthy individuals. Although limitations to the study mean it is premature to link blood type with COVID-10 outcomes, the data suggest a connection may exist.
More Information
On June 25, the CDC expanded its list of underlying medical conditions that increase a person’s risk for severe illness from COVID-19. Those conditions include obesity, chronic kidney disease, type 2 diabetes, and sickle cell disease. Also added were conditions that might put people at an increased risk, including asthma, smoking, cystic fibrosis, liver disease, pregnancy, an immunocompromised state, and type 1 diabetes. See the full list on the CDC site.
Taking precautions, such as limiting interactions with other people, until a vaccine is available is the best way to prevent COVID-19. If you feel sick and think you may have COVID-10, seek medical attention within 24 hours and isolate yourself from others in the household.
Sources: BioPharmaReporter.com, Moderna Secures Fill-Finish Capabilities for COVID-19 Vaccine, https://www.biopharma-reporter.com/Article/2020/06/29/Moderna-deal-with-Catalent-for-fill-finish; Centers for Disease Control and Prevention, Coronavirus Diseases 2019 (COVID-19): Considerations for Wearing Cloth Face Coverings, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html; CDC, Symptoms, https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html; Fierce Biotech, Moderna Finalizes Design of Phase 3 COVID-19 Vaccine Trial Ahead of July Start, https://www.fiercebiotech.com/biotech/moderna-finalizes-design-phase-3-covid-19-vaccine-trial-ahead-july-start; New York Times, Coronavirus in the U.S.: Latest Map and Case Count, https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?action=click&module=Top%20Stories&pgtype=Homepage; San Diego County.gov, Coronavirus Disease 2010, Safer at Home, https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/2019-nCoV/health-order/; STAT, COVID-19 Vaccine from Pfizer and BioNTech Shows Positive Results, https://www.statnews.com/2020/07/01/covid-19-vaccine-from-pfizer-and-biontech-shows-positive-results/; Texas Medical Center, Blood Type May Affect COVID-19 Outcomes, Study Shows, https://www.tmc.edu/news/2020/06/blood-type-may-affect-covid-19-outcomes-study-shows/
Graphics: CDC, https://www.cdc.gov/coronavirus; Ohio.gov, https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home.
