By Veronica Perry
On Thursday, April 30, Price Talks: Policy in a Pandemic featured a discussion with Laura Mosqueda, dean of USC Keck School of Medicine. USC Price Dean, Jack Knott, introduced Mosqueda, highlighted her expertise in both family and geriatric medicine. Being on the frontlines of the pandemic, Mosqueda shared insights about the current medical realities of COVID-19 and what can be expected in the future.
Mosqueda addressed the fact that the majority of people who contract COVID-19 can experience very mild symptoms or no symptoms at all. Some individuals may not even realize their symptoms were caused by the virus, while another group of individuals require hospitalization due to extreme illness. Said Mosqueda, “We know that people are actually dying from COVID-19, and those tend to be the people who I take care of as a geriatrician. Older adults are disproportionately affected.”
After the virus enters a cell in the body, it attaches to a receptor cell known as the ACE-2 receptor. Many of these receptors can be found in the respiratory system, which Mosqueda cites as the reason the virus has such significant effects on lung functionality. “Once it gets into a cell, it takes over the cell and begins to just turn the cell into a little virus manufacturing machine. And once it does that, it then is able to produce and spit out the virus into your bloodstream,” Mosqueda explained.
She went on to clarify that the body also has cells called antigen presenting cells, or APCs. These cells absorb a cell containing the virus and present it to a T helper cell. “The T helper cell then tries to activate two systems. One system called the cytotoxic T cell goes after cells that are infected with the virus and tries to get rid of them from our body. The other system it activates through something called B cells actually produces antibodies,” she explained.
“For the first few days that you’re contagious you might feel fine; you might not even know that you have any illness and you might continue that way, or you might start to get symptoms that are mild, moderate or severe. And during that time, you’re infectious,” she said. Even if patients who have contracted the virus with severe symptoms start to feel better, Mosqueda advised these individuals to wait before going anywhere because the virus is known to return after a few days, causing patients to feel extremely ill again. Once an individual is truly symptom free for 72 hours, they are considered no longer contagious and can resume sanctioned shelter-in-place activities.
Mosqueda showed the Zoom audience graphs reflecting hospitalizations related to COVID-19. She touched on how the disease affects those over the age of 65 and those with chronic illnesses. “Even though certainly people between the ages of 18 and 40 get COVID-19 and become positive, their likelihood of getting a severe illness is dramatically less than those who have chronic illnesses and particularly with older adults who have chronic illnesses,” she said.
Next, Mosqueda addressed the two types of testing for the virus: diagnostic testing (PCR) and serologic testing, which looks for antibodies. Diagnostic testing determines the presence of the virus in the body while serologic testing determines if your body has developed antibodies to aid in long-term immunity. However, Mosqueda said that “unless we have a highly specific antibody test, we can end up with a statistical conundrum of not knowing how reliable it is if we say you’re positive for the IgG antibody.”
She further explained that even if someone tests positive for the IgG antibody, there is still uncertainty surrounding how long someone can remain immune. According to Mosqueda, some types of immunity are better than others. “If it were me and I tested IgG positive, I would not be thinking that that’s a get out of jail free card,” she said. She concluded her conversation by reviewing prevention methods such as social distancing, hand-washing with soap and water, and hand sanitization with a solution containing over 60% alcohol.
Mosqueda noted the development of a variety of vaccines that she hopes will be available within a year or so; but until then, she discussed multiple treatment methods being utilized to treat COVID-19 symptoms according, including various tests and clinical trials that are taking place at Keck School of Medicine at USC.
She ended with an appeal to her audience. “Let’s be kind and really limit our activities so that we don’t get folks sick,” she said. “We never know who walking around with us is immunocompromised, maybe getting chemotherapy for cancer, etc. Be kind to yourself, be kind to other people, turns out being kind to other people is not only good for them, but it’s good for you. It’s good for your immune system.” Mosqueda urged listeners to stay socially connected and to reach out to those who may be struggling.
Many questions were asked regarding testing capacity and accuracy, availability of effective medication, treatment for coronavirus fatigue, solutions for asthmatics and those suffering from autoimmune disorders, and how the students at the Keck School dealing with the virus. The full conversation and Mosqueda’s responses are available to watch here. Register for future Price Talks and join in on discussions related to the critical policy issues facing the world.
Some information mentioned in the article may have since evolved.
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Price Talks: Policy in a Pandemic is a virtual series examining policy challenges around the COVID-19 pandemic. USC Price faculty share their expert perspective on the critical issues that are important to us all in lunchtime Zoom presentations open to the public and Price community. Topics include examining the impact of the crisis on the economy, the homeless crisis, voter turn-out in this year’s election, local government services and our public health infrastructure. Learn about our upcoming talks here: https://priceschool.usc.edu/covid-19/price-talks-policy-in-a-pandemic/