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Remember the Discovery Channel show “Mythbusters” that ran for 15 years? The team of Adam Savage and Jamie Hyneman would test various rumors or adages to see which were Confirmed, Plausible, or Busted.
I sought to do that with key coronavirus questions. But the truth is that it is still so early in our understanding of the virus that nearly everything should fall into that plausible category.
Oh, sure, we can eliminate the goofiest of theories, just as the World Health Organization’s website does. No, this is not spread by 5G cell towers. No, drinking heavily does not protect you from the coronavirus. No, antibiotics won’t help, neither will garlic. You can’t tell if you have it by whether or not you can hold your breath for 10 seconds. You get the idea.
But with many of the more serious topics around COVID-19, the answer is complicated, with a large dash of the unknown thrown into the mix. Even without definitive answers, though, you deserve to know about the current state of the research. So let’s look at five big questions:
Are men more likely to get COVID-19? And do they get sicker?
Thirty-seven U.S. states report the gender of people infected with the coronavirus, according to The Washington Post. In 30 of those states, there are actually more women than men who have tested positive.
Only 13 states report the gender of deaths, but in all 13 states, more men die from the disease. In New York City, about 62% of deaths are men.
What’s happening in Utah? Well, men make up 54% of the state’s cases, bucking the trend nationally. And at least 13 of the state’s 21 deaths involve men, while in five cases the victim’s gender was not identified.
Why do more men die?
Well, there is a well-known difference in the immune systems of women and men. Women tend to have stronger responses, which is a good thing for some diseases and a bad thing for others: sometimes, a strong immune response can attack the body too hard. In the case of COVID-19, it appears that the strong immune response is a good thing.
That being said, the effect may be less than the statistics would indicate. One New York City study of 4,103 virus carriers, of which about 2,000 were hospitalized, found that “gender was no longer one of the most prominent risk variables” once you took into account comorbidities, or other bad health conditions people have. Essentially, the men were more likely to be unhealthy, so once you adjusted for that, the gender effect diminished greatly.
What is the most dangerous preexisting condition to have in combination with COVID-19?
Previously, World Health Organization data indicated that some of the most dangerous conditions to have with the coronavirus were heart disease, diabetes, respiratory disease and cancer.
But that NYC study referenced above showed that actually, obesity was the condition with the strongest association to critical illness, “with a substantially higher odds ratio than any cardiovascular or pulmonary disease.”
The doctors who wrote the study believe that obesity is leading to worse outcomes because it is a “pro-inflammatory condition,” and some of the most dangerous patient outcomes are caused or worsened by this tendency.
Again, it’s difficult to tease out the cause and effect here. People with heart disease, respiratory disease, and diabetes are significantly more likely to be obese than the population as a whole.
How much does smoking play a role? What about vaping?
That NYC study had a third surprising finding: they “did not find smoking status to be associated with increased risk of hospitalization or critical illness.” They believe that to be consistent with previous research on acute respiratory distress syndrome, which is one of the final stages of COVID-19 deaths and severe illnesses.
Another review of five Chinese studies resulted in similarly mixed messages. In nearly every study, smoking rates were higher in the hospitalized or deceased patients than they were in the mild cases. But frequently, the differences in percentages was too small for the impact to be declared statistically significant.
Given the damage we know smoking does on the lungs, you might expect to find huge differences, but that’s not really the case. Smoking clearly doesn’t help, but its impact is probably somewhere from neutral to moderately bad with regards to COVID-19.
Meanwhile, there’s just no research I could find on the effects of vaping. The Food and Drug Administration, though, did just give a statement on the matter to Bloomberg News, saying: “E-cigarette use can expose the lungs to toxic chemicals, but whether those exposures increase the risk of COVID-19 is not known.”
What about hydroxychloroquine? Is that an effective treatment?
At this point, the hydroxychloroquine question is as much a political question as a scientific one, thanks to President Donald Trump’s promotion of the drug and the promotion by some Utah lawmakers. I’m pretty uninterested in the politics of it all, quite frankly.
An initial study from France showed that hydroxychloroquine might reduce viral load in COVID-19 patients, but it was a small study — only 42 patients.
A more recent study of 181 French patients — still small, but less so — found that hydroxychloroquine wasn’t effective in hospitalized patients, and eight even had to be taken off the drug after experiencing “electrocardiogram modifications."
That one study isn’t decisive, either. There are others, though, that have looked at the effect of the drug in hospitals and have generally found no result.
There is a shortage of completed studies looking at hydroxychloroquine usage early on in the virus’ growth, before someone has to go to the hospital. One such study is being undertaken locally by Intermountain Healthcare and University of Utah Health, which plan to work with 2,000 coronavirus carriers who are managing their symptoms from home.
As Samuel Brown, one of the Utah study’s principal investigators said, "The likelihood is that hydroxychloroquine does not have an effect. We hope it might have a moderate effect, but that’s not at all clear.” If it did have a moderate effect, though, that would be excellent news.
Unfortunately, the first study has created demand for hydroxychloroquine that has exceeded supply in some cases, and that’s been rough for those who definitely need it: those with malaria, lupus, and rheumatoid arthritis.
How long will it be until there’s a vaccine?
A 12-18 month timeline is pretty frequently reported and used by the top scientific minds, from Dr. Anthony Fauci on down. But there’s real disagreement on that.
Some vaccine experts think that’s “ridiculously optimistic,” as a CNN article quoted Dr. Paul Offit as saying. And he’d know: he’s the co-inventor of the successful rotavirus vaccine. Vaccines normally take multiple years to produce.
Others, though, are exploring pathways that could see a vaccine produced much more quickly. One U.K. effort is pegged to be released for the end of the year, and perhaps as soon as July. That’s only possible if things go well, though, and as with any given vaccine, odds are probably against it.
Meanwhile, Bill Gates in the U.S. has proposed building seven vaccine production plants, to be ready to produce whichever vaccine does make it out of trials. While it might cost billions of dollars, and most of those plants will be wasted, a successful vaccine would be produced more quickly if construction and production is ready to go for the one that tests well.
Those trials will certainly go quicker than for a normal vaccine due to the importance of finding one. Most vaccines have to complete animal trials before moving on to human ones, but there may be enough human volunteers who are willing to try various vaccines for the good of the world. And certainly, funding won’t be lacking.
Based on my reading, and the effort that essentially every scientist around the world is putting into the effort, I’d bet that a vaccine will be created before the 12-18 month window. At first, the vaccine will be available to those who need it most: doctors and high-risk individuals. Then, it could take some time before production comes in the billions for everyone who needs it throughout the world.