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Nov 23, 2020
Staying Vigilant in the Fight Against Coronavirus

Approximately 10 months into the global Coronavirus (COVID-19) pandemic, the world is still grappling with outbreaks and stay-at-home orders. The good news is that some of the vaccines being developed have shown high efficacy rates in clinical trials, but with widespread vaccine availability still projected to be months away, we all  must continue taking action to keep ourselves, our loved ones and our essential health care workers safe.

To better understand the progress we’ve made in the fight against COVID-19 thus far, and also where we’re headed, Cigna’s Chief Clinical Officer, Dr. Steve Miller, answers some frequently asked questions.

As we see COVID-19 cases ramp up across the United States, what are the best ways we can help prevent the spread of the virus?

The vast majority of infections occur from exposure to droplets. So, wear a mask and wear it properly, and keep more than six feet apart from others. Make sure to clean surfaces often.

Get your flu shot if you haven’t already. We know that the flu-vaccinated population experiences more mild cases of COVID-19. So while getting the flu vaccine doesn’t work directly against COVID-19, it primes your immune system and seems to make you a little more resistant. Also, consider taking vitamin D supplements – about 2,000 units per day – because it can’t hurt you and may be beneficial. We’ve seen that coronavirus patients with low vitamin D levels have a much tougher time, and we know that in America a fair number of the population is vitamin D deficient.

As we enter the holiday season, we expect the number of COVID-19 cases to continue rising. As vaccines become available, those numbers should slow. But there’s no question, this is going to be a tough winter.

People really need to be prudent because all of us have that desire to be with family and friends around the holidays, but this may be the year we have to skip that. It is incumbent upon all of us to make those sacrifices, limit the number of people we share the holidays with. And if you can't do that, please do everything in your power to make sure it's safe by practicing social distancing, good hand hygiene, and properly wearing a mask that covers your nose, mouth and chin.

What testing is most reliable?

There are two types of diagnostic tests. Let’s start with the rapid tests that give you an answer within 15 to 30 minutes. They're testing for the presence of specific proteins found on the surface of the coronavirus. If you have a positive rapid test and symptoms, you should assume you are infected and take precautions like quarantining and getting appropriate treatment.  If your rapid test is positive but you have no symptoms, then you need to confirm by getting the second type of test, a PCR, as you maybe a false positive. 

If you have a negative rapid test, that’s good but it doesn’t mean you're not infected -- it means you have either none, or very low amounts of virus, which, by itself doesn’t paint a clear picture. In that case, it’s best to then get a PCR test to confirm a result.

The PCR test is more specific and is sent off to a laboratory for analysis.  Results usually take a day, but can take up to a week depending on demand.

Remember that the incubation period is typically 3-5 days but can be as long as 2 weeks.

The best way to protect yourself from exposure to COVID-19 is to assume that any new people you're bringing into your bubble are infected. Don’t wait for test results to be cautious. Remember that the incubation period is about 14 days at most. Wear a mask around them, keep your distance, and after the full 14 days without symptoms, you'll be able to return to normal activities together.

What can you share about COVID-19 long-haulers – the people that continue to have symptoms long after testing negative?

People who are the most symptomatic have the highest risk of developing long-term complications involving the lungs, heart and nervous system. We also know that those who are asymptomatic can still have some of these symptoms, but it's generally much less severe.

We’ve only had about 10 to 11 months of observation of COVID-19, and there is a lot left to learn. We’re working with specialty clinics around the country and globally to make sure that we’re cataloguing truly what is the risk for these patients. We’re responsible for the health care for these patients and we really want to make sure that we’re getting them to the right place, and getting them the best care and the best chance for full recovery. But, at this point, there aren’t any specific therapies available for long-haulers except providing supportive care for their symptoms and lung, heart, or neurologic disease.

The bottom line is that we all should be really leery about getting the coronavirus. It’s not benign and it’s much more serious than the flu. Even though the mortality rate has come down dramatically, you don’t want to be one of those long-haulers.

Some vaccines have had great results in early clinical trials. What can you tell us about the vaccination and distribution plans? How confident should we be with these products?

The excitement around vaccines is really ramping up, and coming off of successful clinical trials, two drug makers have sent their products to the FDA for emergency use approval and others aren’t far behind. I’m very confident in these products, and am even participating in a clinical trial myself.

Many drug makers are already producing large quantities of their products, and it’s projected that starting in December, there should be enough vaccines available for 20 million people.

When it comes to getting this vaccine out to the public, we expect the government will handle distribution of the first doses, and that they will go to front-line health care workers. The second group will be high-risk elderly populations, particularly those in long-term care settings, and that’s likely to be in late January or early February. If all goes as planned, vaccines should be widely available in communities by April or May.

The bigger concern for me personally, is making sure people get the vaccine. To ensure herd immunity, you have to get more than 60 percent of the population immune, which is nearly 200 million Americans. Now, if we could vaccinate half of the population and then we take the percent of the population that’s already been infected, we should be close to 60 percent. I do believe that many who aren't excited to get vaccinated will gain confidence as more and more of their friends and neighbors get safely vaccinated.

Visit Cigna's COVID-19 Resource Center to learn more.