Last night Mum disappeared off to her room in the middle of making a salad. We waited for a while, not thinking anything was amiss, but then our proposed dinner time came and went so we thought we had better check on her. We found her getting into bed saying that she didn’t want to bother us, but she had felt dizzy and sweaty and thought she should take herself off. The world shrank into a circle of minor mental panic. I took her temperature; 37 deg C is a slightly raised temperature for an older person but not in the realm of concern. No cough, no sore throat, no loss of smell or taste. Probably not COVID-19. When might she have been in contact with anyone? The nurse when she got her flu shot? That was 3 days ago, so a bit soon for COVID-19 symptoms. Could it be a reaction to the flu shot? Look that up on line. Normally reactions occur within 2 days. She hasn’t been anywhere or exposed to anyone else for many days. So don’t panic, most likely nothing much (lizard brain says PANIC!!!!). We took ourselves off to watch an episode of Ozarks while regularly checking in on Mum to see how she was feeling (a bit annoyed by the constant visitations).
Thankfully, by midday today, Mum is fine. Come this morning her temperature was down to 36 deg C, decidedly normal. She said she was much better while still in bed, and looked it. She even had some toast for breakfast. By lunch time she was feeling well enough to get up and have soup at the table with us. Storm averted, phew.
That wasn’t the only health panic of late, however. I imagine we are not the only people in New Zealand who are overreacting to and over-interpreting minor physical symptoms. Three days ago Chris was super grumpy when I got up. When I asked what was wrong, he said he hadn’t slept much because his neck was really stiff. Neck stiff…could that be COVID-19? Check on line…the symptoms don’t include stiff neck. But could it be meningitis? Check meningitis symptoms online (do we thank the internet for information this point, or curse it for suggesting all the possible ills?). Could Chris bend his head forward? Yes, he just can’t turn it sideways. Therefore his problem is not likely to be meningitis. What’s his temperature? It’s under 36 deg C; no fever means he is not likely to have either meningitis or COVID-19. Could it be just a ‘stiff neck’?
I tried manipulating his neck and shoulder muscles to see what was going on. That hit the neural jackpot – the left side of his neck was extremely tense. It isn’t too surprising, someone being tense at present. In fact it is pretty easy to think of quite a long list of reasons that one might be tense, including waking up with a sore neck in the middle of the night and wondering if you have something lethal, or at least bad enough that you might need to go to a potentially COVID-19 ridden medical facility. The cure, taken somewhat reluctantly, ended up being deep breathing, stretching, sitting in a comfortable chair reading a book, and time.
On a science note, I was asked by my friend Cath how valid the science appears to be around use of ‘convalescent plasma’ to assist with immunity to or treatment of COVID-19. Use of convalescent plasma isn’t new; there is an established protocol for taking the blood from someone who has had a disease, extracting the plasma (which contains antibodies that the person has manufactured against the disease), and injecting that plasma into someone else who has the disease. This gives the second person a temporary assist by giving them existing antibodies that can mount a defence, before the person themselves mounts an effective immune response. It is useful where there is no vaccine or treatment method.
Convalescent plasma has been trialled for treatment of viral disease including Ebola and MERS (we don’t need it for bacterial infection as we have antibiotics), but no rigorous clinical trials have been carried out, and its efficacy is still not clear. There are attendant risks in transferring blood plasma; it is possible to infect the person it is transferred to with other diseases from the plasma, unless these are carefully screened against! There are also ethical considerations around taking plasma and donating it.
Because of the lack of options for treatment of people seriously ill with COVID-19, there has been considerable interest in the use of convalescent plasma. Some studies in China showed positive results, therefore on 3rd April the FDA approved a clinical trial by Johns Hopkins for protection of healthy people through use of convalescent plasma, which expects to deliver results by the end of April. Another trial, for use in slightly to moderately ill people, is awaiting FDA approval to commence. If convalescent plasma proves to be of use, there will still be limitations as to its applicability. One person can only donate plasma for two to four other people – it is not a population-scale solution. Plasma collection, processing and injection will use a considerable amount of medical resource to enact – every health effort that takes place means some other activities cannot take place; medical staff and researchers are not an infinite resource. In addition, some people produce few antibodies, particularly those who are mildly ill with COVID-19 or asymptomatic, so will be no use for production of convalescent plasma.
However, convalescent plasma remains another potential tool in the arsenal, with real-time research experiments underway. It it rarely so abundantly clear how medical research and science deliver improved human wellbeing. Hopefully this will be a take home message from COVID-19 to a world which has been increasingly sceptical of late of both science and its never-ending quest for truth.
Finally, my friend Paul asked me if I could find more positive things to write about that will ensue from the COVID-19 pandemic. I hope I am putting some positive notes in, including in my dystopian stories, but I will admit that sometimes it feels pretty hard to see a hugely positive side to this event. In the interests of countering negativity, I will endeavour to always remember the following: