Questions and answers with Dr. George Diaz, infectious disease expert



The central theses:

  • The Providence doctor, Dr. George Diaz, treated the first COVID-19 patient in the US.
  • Dr. Diaz discusses the benefits and research behind clinical trials of COVID treatments.
  • People with compromised immune systems are at higher risk of breakthrough COVID infection.

COVID-19 continues to spread in many of our communities, and when children go back to school, parents consider working remotely versus office, and others weigh the risk of attending events, many questions arise. That’s why Laurie Kelly, Providence’s Chief Philanthropy Officer and Senior Vice President, met with infectious disease expert Dr. George Diaz put together to get answers to all COVID questions.

Dr. Diaz is the Infectious Disease Section Head and Medical Director, Antimocrobial Stewardship and Infection Prevention at the Providence Regional Medical Center in Everett, Washington. Perhaps the most important reason Laurie and Dr. Diaz said is that he was one of the first doctors in the country to treat a COVID patient. Everett, Washington saw the very first patient with COVID-19 in the U.S. and Dr. Diaz provided this first patient with a drug called remdesivir. Shortly thereafter, the Providence healthcare system became very active in clinical research for COVID treatments. To date, Providence has been involved in several clinical trials of COVID treatments, including:

  • Remdesivir
  • Tocilizumab
  • Monoclonal Antibodies (Regeneron)

You can watch the full conversation between Laurie and Dr. Watch or listen to Diaz answering general questions about COVID along with audience questions, and you can also read highlights from their conversation below.

What is a clinical trial?

Dr. Diaz: Clinical studies help us find out whether a treatment is working. In general, these are placebo-controlled studies, which means we compare a study drug with a placebo to see if there is a difference in results between taking a study drug and taking a placebo. This is how we can prove that the treatment is working. And once we prove that, all of the patients you know around the world can use these treatments for COVID or any other clinical condition that is being studied.

Clinical trials are the way we are moving forward in the treatment of COVID. And thanks to the many volunteers in our country, we have made important discoveries to reduce the risk of dying from COVID in the United States. Clinical research is very important in helping us learn more about disease management, but it has been particularly helpful with COVID.

What is remdesivir?

Dr. Diaz: Remdesivir is an antiviral drug, which means it blocks the COVID virus’ ability to replicate in a person. The National Institute of Health conducted studies that initially found that people who took the drug when they had COVID had a shorter recovery time and also showed a possible improvement in mortality. At Providence, we’ve followed up on that work and found that remdesivir appears to reduce the chances of dying from COVID by about 40% when started at the right time, that is, when someone is hospitalized with oxygen. This Providence clinical research was also called in a journal. released Clinical Infectious Diseases.

What is the Delta variant?

Dr. Diaz: The delta variant is a type of COVID-19 that has been mutated or altered and is different from the original COVID-19 strain. The Delta variant also seems to be much more contagious. The original strain of COVID that we saw in January 2020 could infect an average of two or three people per person infected. In the delta variant, it seems to be much more contagious and an infected person can infect between six and nine people. So it’s radically more contagious than the original strain. In addition, it appears to be a more virulent virus, meaning that it does more harm to people than the original virus.

You could say it’s a double punch: it’s much more contagious, so more people can become infected, and it’s more contagious, so more people end up in the hospital compared to the original strain.

How do people become infected with COVID-19?

Dr. Diaz: The Delta variant of COVID is transmitted the same way as the original strain. The transmission occurs mainly when breathing, coughing or sneezing. And the virus tends to stay in the air longer if there isn’t good ventilation, especially indoors. The main risk factor for transmission is someone who has a COVID-19 infection and is generally indoors with another person. If there are large crowds outside and they are close together, it is certainly possible that there is also an outdoor transmission. Wherever people are in close proximity outside, COVID (and other things like colds and flu) can be transmitted in other ways. Transmission through your hands, e.g. B. by touching objects is much less likely, but certainly still possible.

Who Has Breakthrough COVID Cases?

Dr. Diaz: There are two components that we need to talk about when discussing breakthrough cases. The first is People who are vaccinated and who then have a breakthrough infection and get sick enough to go to the hospital. In general, that’s a very small number of people. If you look at the patients in our hospitals, about 90 to 95% of the people in Providence are currently unvaccinated.

Of the remaining small percentage of people who are vaccinated and get a breakthrough infection, these are people whose immune systems did not initially respond very well to the vaccine. People who are immunocompromised from organ transplants, chemotherapy, and similar conditions where their immune systems aren’t working can develop a breakthrough infection. These are the people who are hospitalized primarily with severe infections.

Patients with immunodeficiency in our community that is not just a small number of people (people with moderate or severe immunodeficiency are approximately 7% of our population in the US) are most susceptible to breakthrough infections and real illness. The way we protect them is to prevent exposure and that means they will be vaccinated. Also doing the things we know work like masking and social distancing. These things will help keep the most vulnerable in our community safe from a breakthrough infection.

What about pregnancy and COVID-19?

Dr. Diaz: Pregnant women are more likely to get a serious infection and be hospitalized if they get COVID-19. That is known. For this reason all national groups that treat pregnant women Recommend COVID-19 vaccination during pregnancybecause it seems completely harmless. In addition, the immunity created by the vaccine will also protect the child. It is very important for pregnant women at every stage of pregnancy to get vaccinated against COVID-19. There are currently so many COVID-19 infections in our country that the risk of infection is actually very high in pregnant women.

Dr. Diaz discusses these topics along with the topics below in the video above. Watch the video to learn more about:

  • The delta variant
  • Current hospital stays
  • Ivermectin
  • Probability of contracting COVID multiple times
  • Children go back to school
  • How to speak to someone who is hesitant about vaccinations

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