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Six months in, Johns Hopkins experts weigh in on the coronavirus: ‘We are really still in our first wave'

Half a year has passed since the coronavirus entered our world, and a group of experts from Johns Hopkins University say they agree on one thing: The pandemic isn’t over and still could get worse.

“There has been much discussion of a second surge, and usually by this we mean something that comes in the fall when we have other respiratory diseases as well,” said Dr. Lisa Maragakis, senior director of infection prevention for the Johns Hopkins Health System. “We are really still in our first wave.”

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Maragakis offered insight Wednesday on where the virus was headed during a panel discussion with colleagues focused on aspects of COVID-19 that included pediatrics, disparities, contact tracing and therapies. There is no vaccine and there are a lot unknowns, but the officials have learned ways to control the virus — if people listen.

Maragakis called the numbers so far “staggering:” more than 8.2 million cases and 446,000 deaths worldwide, and more than 2.1 million cases and 117,000 U.S. deaths.

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More troubling, she said, are increases in many states likely due to reopening and some protests over the killing of George Floyd.

She called for consistent messaging on wearing face masks, distancing between people and hand-washing to prevent infections. She also said the country needs more testing for cases and tracing of those exposed so they can be isolated.

Also needed is sufficient protective gear for health workers and disinfectants. Labs need such things as reagents used in processing tests.

Some good news is that the virus has infected fewer children than adults, said Dr. Aaron Milstone, professor of pediatrics in Hopkins’ School of Medicine.

A concerning development is multi-system inflammatory syndrome, which can cause inflammation in the heart, lungs and elsewhere in the body after a COVID-19 infection. There have been hundreds of cases and a few deaths from the syndrome, which requires aggressive treatment, but it’s still considered rare.

Children also need to wear masks and keep their distance if they have play dates, Milstone said. He also said parents should expect camps, sports and school will look different for the next six to 12 months, with shorter days and smaller groups.

“We need to continue to follow precautions and not just with who we think of as in vulnerable populations like those in nursing homes and elders,” he said. “We need to keep children safe, too.”

That’s not to say everyone is affected in the same way, said Dr. Sherita Hill Golden, vice president and chief diversity officer at Johns Hopkins Medicine. Black people, Hispanics and Native Americans are disproportionately becoming infected, with African Americans, by far, disproportionately dying.

African Americans are dying at a rate of about 62 per 100,000 people versus white people whose rate is closer to 26 per 100,000 people.

A lot of that has to do with systematic racism in health care, as well as lack of quality housing and schools and community investment, she said. African Americans are more likely to be uninsured or distrustful of the system. This has led to higher rates of heart disease, diabetes and other underlying health conditions, making people vulnerable to COVID-19, Golden said.

Minorities also fill many more essential jobs in transportation, retail and food service, and are disproportionately incarcerated in crowded facilities, putting them in harm’s way. Ongoing protests “have the same root in structural racism,” she said.

She echoed the calls, specifically for protesters, to take safety precautions.

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As protests continue and states more widely reopen, more people will become infected, said Crystal Watson, senior scholar at Hopkins’ Center for Health Security. A crucial element to “break the chain of transmission” will be contact tracing, which is identifying those exposed to the virus.

Watson said 100,000 public health workers are needed nationwide for calls. State such as Maryland are making progress, but many states are falling short.

“We need a massive workforce upgrade,” she said.

Those tools will remain in place until vaccines and treatments are developed and tested, said Dr. Shmuel Shoham, associate professor of medicine in Hopkins’ School of Medicine.

He specifically cited convalescent plasma as a promising therapy. The plasma, taken COVID-19 survivors’ blood, contains antibodies that may fight off the disease in others or treat those in early stages of the disease.

Information on trials is available at covidplasmatrial.org.

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