By Brian Indre
Autumn is here, and as the temperature drops and the risk for Covid-19 spikes increases, doctors emphasize how important accurate testing is as well as the possibility of an effective vaccine, while healthcare professionals offer advice on how to boost your immune system.
If the predicted upcoming surge in coronavirus cases creates a need for testing similar to the most recent one — which stretched from Memorial Day through a couple weeks after the Fourth of July — Dr. Gordon Theisz, the head of Family Medicine in Falls Church, explained that the testing capability will be overwhelmed and it will take longer.
It would be similar to the initial outbreak of the virus in Northern Virginia. During the peak of the pandemic in the spring, trying to get tested and knowing where to go was confusing, and oftentimes the test results took weeks to get back, which at that point wasn’t helpful. So Theisz, being one of the few private practices not tied to INOVA in the area, found a way to make his own tests.
“Coordinating with test labs we were able to make our own test kits, since getting them has been a challenge throughout the pandemic,” Theisz said. “If you couldn’t get test kits or get the materials to make them, or your staff was afraid of getting Covid; you did what a lot of doctors did, and closed the office and did televisits only for months.”
Quest Diagnostics and LabCorp sent instructions for how private practices could make their own test kits, and with the materials on hand to do it. As a result, Family Medicine said they never stopped testing.
“It would have been a challenge if we only had ten test kits in the office, and then having to decide who to use them on,” Theisz continued. “You should use them on everyone because Covid has symptoms that lead from nothing to terrible.”
The polymerase chain reaction, or PCR, test is the most common way of checking for virus symptoms. It’s performed by using a large nasal swab and inserting into someone’s nose to gather a DNA sample. Theisz said that the relatively low number of positives, which he mentioned was about two to three per week, have made its three-day turnaround not much of a problem.
However, with some schools and workplaces reopening, more people are being required to get tested, and some people want to get tested because they will be traveling or believe they were exposed and want to be sure they aren’t a silent carrier.
Family Medicine has accommodated more on-the-go testing options, such as drive-up testing done by appointment only, and the staff can help determine if you need to be tested.
“We try to keep people that are sick out of the office until we are confident that whatever they are coming in for is not Covid,” said Theisz. “In addition to office visits, about 10 percent of appointments are televisits, which has gone down from around 50 percent during the height of the pandemic.”
Even quicker tests are being used in certain markets. The FDA has issued an EUA (emergency use authorization) for a couple different saliva-based tests for Covid, one developed at Rutgers University and the other at Yale University.
The Yale test called SalivaDirect is funded by the NBA, and will be the much cheaper option for patients because it doesn’t extract RNA (ribonucleic acid), which is what is needed for results for the Rutgers test and the nasal swab tests.
“It’s probably a promising test, but I’d have to review the statistics on it,” Theisz said. “When a test has an EUA, data has to be provided to the FDA on how accurate it is, and these tests are not fully studied like that of most tests that have years of evaluation.”
Those who were sick in the spring may be curious about antibody testing to see if they may have had Covid previously. Unfortunately antibody testing isn’t always accurate and can even produce a false-positive result. For those who do have a positive antibody test, it is unknown if it will protect you from getting infected again and it doesn’t indicate if you can infect others.
“We have no idea what having antibodies to Covid really means, so if you have a positive antibody test, we can’t say for sure that you are immune. It would be nice if you were, but we tell those patients to go with the social norm, which is everybody should wear a mask in public,” said Theisz.
“Within two weeks of March 13, chances are that someone feeling ill had had the flu, but after about April 1 there was no more flu, so that is where we will see the positives for Covid,” Theisz said. “And most of the positive antibody tests tend to be people who knew that they were exposed to it.”
When a vaccination becomes available to the public with adequate published data which includes reported side effects, efficacy, and everything else that medical professionals will want to see, then Theisz says he would recommend it and get it himself.
“The problem is that the timeline of the vaccine has become political. If a politician is saying that we are going to have a vaccine before the election, a lot of people would suspect that there is a problem with it, and I would be a bit skeptical of a vaccine that gets EUA from the FDA, if there seems that there were pressure from the administration to get it out,” said Theisz.
And when a vaccine is available, should the public trust it right away?
“I would want my doctor to tell me why they think this is a good vaccine,” said Theisz. “We are going to rely on the government and the FDA to tell us the vaccine is okay, and the moment they find out that it is not okay, we are going to rely on them to pull it and say no more,” he said. “If you see that kind of stuff happening then you know that the research has been done right.”
But before even getting to the point that someone may feel sick enough to need a test, it’s important to know what they could do to improve their body’s condition so warding off the virus is all the easier.
Megan Pennington is an integrative health practitioner who specializes in chronic illness and immune system health and overall nutrition. Although she resides in Canada, she has many patients who live in the U.S. She told the News-Press to offer some expert advice on how Vitamin D can play a role in your immune system response to Covid and other viruses.
Pennington explained that her approach to helping the immune system to work optimally is to decrease inflammation, because inflammation is the underlying mechanism by which the immune system deals with infection and pathogens.
“If inflammation gets to a point where it’s chronic, then it starts to damage our tissues, and recent research shows that happening with Covid,” said Pennington. “An unregulated immune response or a heightened or hyperactive immune response is creating too much inflammation which is called a Cytokine Storm, and that is what is causing the damage in the very symptomatic and severe cases.”
In order to modulate the immune system or help it do its job properly without over responding with inflammation is to give it the resources that it needs to dampen that inflammatory response, and Vitamin D is one of those resources.
“Vitamin D is a key player in the inflammatory response, and studies show that low levels will allow inflammation to run rampant, whereas adequate levels will have an inhibitory effect on the inflammatory cascade,” said Pennington.
Studies have shown that an estimated 1 billion people worldwide have inadequate levels of Vitamin D in their blood.
“For anyone concerned about their vitamin D levels should get a test done to show their doctor. It can be a safe way of giving your body an extra boost to help respond appropriately to an infection,” said Pennington.