KEARNEY — Aravind Menon, the epidemiologist at Two Rivers Public Health District, admits that much remains unknown about COVID-19. But he has no doubts about wearing a mask during the pandemic.

“Masking works,” he said.

“Since COVID is a respiratory virus that is likely transmitted through the air on particles that are exhaled, it follows that blocking such particles (of spit, dust particles and microscopic pieces of phlegm, e.g.) from entering the mouth and nose would go a long way in stopping the spread of disease,” he said.

Menon, a physician who holds a doctorate in public health from Johns Hopkins University, also cited an article on masking in the European Journal of Infectious Disease. The study used Hong Kong as the base, where masking was early and universal, and which was spared an initial wave, he said.

When COVID spread to Singapore, it started requiring masks. South Korea was harder hit “because people were being careless” about masks.

“It saw outbreaks that were localized to places like churches because people took off their masks there,” he said.

So much remains unknown about COVID-19, including why cases suddenly are increasing in Buffalo County. While many of Dawson County’s 900-plus cases were tied to packing plants there, there’s no easy explanation for Buffalo County.

“It is difficult to point to any one source of infection,” he said. Because symptoms take from two to 14 days to develop, infected people in the early stages are likely out and about and infecting others without knowing it, he said.

“Infections among people up to age 29 may have hastened this process, given that young people get the disease at the same rates as adults, but are less likely to exhibit symptoms, and subsequently, to get tested,” he said.

‘A strand of DNA’

As an epidemiologist, Menon said coronaviruses are responsible for common diseases in humans and have been responsible for diseases such as SARS and MERS, both of which had a combined caseload of about 10,000 people. A new strain of SARS causes COVID-19.

Basically, it boiled down to “just a strand of RNA,” Menon said.

That strand mutates regularly, but “this shift is a very abrupt change. We’re almost certain know that the virus that hit Italy is different from the one that came out of Wuhan, China,” he said. Seattle was the first U.S. city with COVID-19 cases.

MERS originated in camels. COVID-19 came from bats.

Menon said that when these viruses move to humans, “it’s like a new civilization. We see a lot of genetic variation in the first six months; then, those variations settle down to a few that can survive,” he said.

“Just one virus may not be very effective. We actually think the virus that caused the outbreak in New York was less lethal, but with so many people in New York, it was more likely to be passed on. Only .5 percent of people got really sick, but so many people got it that the numbers were high.”

“It seems as if what happened in Italy and New York might have had a lot of parallels, so we think it was the same virus. We’re almost certain now that the virus in New York was from Europe, not China,” he said.

Genetic diversity

Asked why, and whether, Hispanics and Blacks appear to be more susceptible to severe cases of COVID-19, again, reasons are not clear, but Menon reached back to human history of eons ago.

“Early European contact in the New World was marked by the massive spread of viral diseases among the so-called ‘first people,’ diseases like flu, measles, smallpox, when the New World met the Old World. In turn, the Old World gave Europeans some unique intestinal flukes and bacterial diseases like syphilis,” he said.

“These are very early days of COVID-19 research, but it is not unreasonable to imagine a different susceptibility between native populations,” he said.

Long-term effects?

Much about COVID-19 remains unknown, such as why infected people lose their sense of taste and smell.

“When you have a cold, the mucous plug in your nose stops the sense of smell. With COVID-19, there is no mucous plug, but people still lose their sense of smell and taste,” he said.

“We’ve also learned that the virus is able to penetrate into the nose and brain and across the blood-brain barrier.”

So far, he said, scientists are not sure if, and/or for how long, recovered COVID-19 patients are immune from the virus. “After a vaccine is developed, we might have to give a booster shot a year or two later,” he said.

Vaccines are a question mark, too. Once one is developed, how quickly can it be manufactured and delivered to billions of people all over the world? “The World Health Organization might have to create zones around the world for distribution. Europe would be one zone, with east and central Africa another, for example,” he theorized.

Praise for Fauci

As COVID-19 rages, Menon has deep respect for the Centers for Disease Control and Prevention (“the gold standard for medicine around the globe”) and Dr. Anthony Fauci, 79, the director of the National Institute of Allergy and Infectious Diseases since 1984. Since January, Fauci has been a member of the White House Coronavirus Task Force.

“America is so fortunate to have Dr. Fauci,” Menon said. “I had a textbook by Dr. Fauci in medical school. He is known and respected all over the world.”

Like Fauci, Menon knows that periodic viruses are part of the global picture. A century ago, the Spanish flu killed 650,000 Americans, far more than the 150,000 who have died so far from COVID-19.

He is cautious about a vaccine and would be “surprised” to see one available by January, as some predict. Effective vaccines require time, patience and painstaking caution, Menon said.

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