Take it from Dr. Stephen Vickery: This too shall pass – just not quite yet.
An assistant professor in Wingate University’s School of Pharmacy, Vickery deals with problematic microbes every day as an infectious-disease pharmacist with Pardee Hospital in Hendersonville. As we talked last week, news reports were coming in of protestors blockading streets in Michigan, Virginia, even North Carolina, demanding that governors reopen their states for business. This week, the governor of Georgia said he plans to make moves to reopen a number of types of businesses.
Vickery says such moves might be a little hasty.
“This novel coronavirus will continue to perpetuate,” Vickery says. “It’s not going to simply be eradicated. We want to get back to normalcy, but it needs to be done in a safe way where we don’t further the spread.” That means testing and contact tracing, since a vaccine is likely a year from availability and there are no known antivirals for the disease, he says.
Vickery is not exactly on the frontlines, but he does know infectious diseases better than probably anybody you know. And before COVID-19 led to massive shutdowns across the country, Vickery and the rest of the Infectious Disease and Antimicrobial Stewardship team at Pardee helped the hospital formulate a plan of attack for treating patients. It was a break from their usual duties, which primarily consist of creating guidelines for how antibiotics are to be used.
Most of Vickery’s work is with bacterial infections, which are the primary microbial problem in western North Carolina. But Pardee does have to treat cases of viral meningitis, influenza and the like. And of course now it is dealing with more than a few cases of COVID-19.
Luckily, stay-at-home measures have been effective in North Carolina, so Pardee has not been slammed with patients the way hospitals in harder-hit areas of the country have. But that doesn’t mean we’re out of the woods yet.
One problem, Vickery says, is that COVID-19’s incubation period is so long that seemingly healthy people can walk around spreading the virus unwittingly for several days.
“The flu acts in a very similar way,” he says. “It’s just that that time frame is much shorter, so you can at least back up and say, ‘Well, what did I do over the past two to three days?’ With COVID-19, you have to go back and think, ‘Well, what was I doing maybe one or two weeks ago? Where did I go in the meantime? Who was I exposed to?’ I think that’s why the drastic measures were needed.”
Unpredictability of medicine
Vickery became interested in infectious diseases during his student days in the Wingate University School of Pharmacy (he’s a 2012 graduate). He was fascinated by how complicated such tiny organisms could be.
The pandemic that has us all locked indoors most of the day has fascinated his students. SARS-CoV-2, as the novel coronavirus is called, could have provided a perfect case study for current School of Pharmacy students, except that those students on rotations aren’t considered essential personnel and therefore can’t observe patient treatment.
But one thing the pandemic does, Vickery says, is give students a taste for the unpredictability of healthcare.
“I don’t think anyone in higher education really signed up for that (online-only education) or was anticipating or expecting it,” Vickery says. “And of course with the goal of preparing students to become pharmacists and healthcare providers, adaptability and flexibility is a part of the game.”
It’s going well, by all accounts. These days, Vickery is working from home like most people, teaching his classes via Zoom and consulting with doctors at Pardee over the phone. His classes, he says, are pretty effective.
“I have not heard or have not seen anything that would remotely hint at the fact that education overall is diminished or that there may be knowledge gaps,” Vickery says. “Obviously, it’s a completely different way in which we’re delivering content. But if anything, we may be able to use this positively going forward. Maybe there are components of education that could be online.”
Stepping back and looking at the coronavirus pandemic, Vickery sees a virus that will require time to fully crack. “Because it’s novel, that means it acts in a way that we can’t quite predict,” he says. And that means it will take time to develop effective antivirals, much less a vaccine.
But Vickery says there have been some encouraging developments. After anecdotal successes, the malaria drug hydroxocholoroquine has suffered a setback in trials, but Vickery says that a relatively new antiviral medication, remdesivir, has shown promise, though his optimism comes with a healthy dose of caution.
“There remains no clear evidence of efficacy for any of the medical interventions for COVID-19, with hopefully some clarity for clinical trials moving forward,” he says. “All patients at Pardee are evaluated on a case-by-case basis for suitability of experimental therapy based on the severity of their illness and potential toxicities of the medications.”
The bottom line is don’t think that we’re going to return to hugs, concerts and dinner parties in the next couple of weeks. But we will ultimately return to life as we knew it, Vickery says.
“I think we’re eventually going to get back to normalcy, whether that’s this fall or maybe the following spring, 2021,” Vickery says. “It’s hard to say for sure, but there is light at the end of the tunnel.”
April 24, 2020
- COVID-19 Community Spotlights