Dr. Steven Bishop returned to Facebook Live on Wednesday, May 6, to provide a weekly update on all things pertaining to COVID-19. He discussed the mutations of the virus (mutations are normal in viruses), how a virus replicates (it forces your cell to focus on making new virus cells instead of what it normally does), and how that affects the virus (as it replicates, it makes small mistakes, which lead to mutations).
He also discussed how mutations might affect vaccine development (vaccines will hopefully focus on the part of the virus that doesn't mutate) and took questions from viewers. Watch the video below and read on for a recap of the full Q&A.
- In Maryland, the first stage of the reopening will include gyms offering outdoor training. What questions would you ask, or what factors would you consider, when assessing a gym's plan to reopen in this way? I would ask a few things.
Are they going to be following a stringent cleaning protocol? Equipment should be wiped down on a regular basis and the gym should provide some sort of sanitizing wipes and/or hand sanitizer so you can use them as you feel comfortable.
If you're going to be within 6 feet of other people, wear a mask. If you are going to do a strenuous activity where breathing will be hard with a mask, avoid doing this at the gym. Do it at home instead.
And finally, any gym should still be following the recommendations on social gatherings, which right now would mean less than 10 people.
- I saw a report on TV last night that they think the virus has weakened some. Have you heard anything about that? In general, as most viruses stick around, they tend to mutate and become tamer or weakened. That is the most common thing for viruses as they mutate and adapt to us as hosts.
For the most part, it's not in the viruses best interest to be too lethal. Viruses, like any other organism, want to replicate. So if they are too lethal, they don't get the chance to spread. The best strategy for a virus is to make you just a little bit sick, so then it can spread to other hosts.
So in general, as viruses adapt to us, they become less virulent, so they can keep spreading to other people.
- Are the mutations likely to make vaccines more challenging to develop? It depends on two things. What part of the virus we are able to target the vaccine to and how quickly that part of the virus mutates.
Some parts of a virus mutate faster than others. If we are able to target the vaccine to a part of the virus that doesn't mutate quickly, it will make vaccine development a lot simpler. That would hopefully lead us to a "one-and-done vaccine."
If we are only able to target a vaccine to a part of the virus that changes more quickly, it will lead to a more complicated vaccine development more akin to that of the flu. Hopefully, we will be able to target a part of the virus that does not change that much.
- The Rite Aid near me has drive-through testing by appointment only. Would you suggest doing this if you have no symptoms? I would not. I believe Rite Aid is using PCR testing, which tests for presence of the active virus, which will probably not give you great information if you don't have symptoms. I would recommend instead trying to get an antibody test. If you do have symptoms, then yes.
- Do antibodies keep you from being contagious at all? If I have antibodies and contract the virus, can I still it spread it to someone before the antibodies do their thing? It depends on which antibodies you are talking about. There are three main types of antibodies that people are testing for: IgA, IgM, and IgG. IgA and IgM show up in the first few days of infection when you are definitely still contagious.
After a couple weeks, the IgG antibodies show up, which are the more long-term antibodies. If you just have IgG antibodies, you have likely recovered from the virus already and are not likely to get anyone else.
That said, IgG antibodies can start showing up as early as day seven, so it is still best to follow CDC guidelines to make sure you are in the clear. If you are 3-4 weeks out with IgG antibodies, odds are you are not infectious to people.
- Do we know how accurate the antibody tests are? Are false positives a problem? Yes, we are seeing some false positive tests, which can be a problem. It is going to depend on the company and the lab. However, I'm less worried about a false positive antibody test than a false negative.
A false positive just means you will quarantine yourself even though you don't have the virus. A false negative might lead you to continue your normal business while unknowingly spreading the business. So, it's the false negatives that are much more concerning.
Steve E. Bishop, M.D.
As a board-certified internist and concierge doctor in Richmond, VA, Dr. Steven Bishop is passionate about helping his patients improve their lives through better health. He helps healthy adults adjust their lifestyles as they age and helps patients with complex medical diseases manage and improve their health.
