Dr. James H. Anderson - Carmel Monthly Magazine

May 2020 To state there is an inordinate amount of information—proven data and theories—on the novel coronavirus (COVID-19) would be a gross understatement. Carmel and Zionsville just happen to have two subject experts residing within the two communities who were gracious to share their time and knowledge on the science of COVID-19 and the medical/scientific facts that the general population should know as we continue to navigate through uncharted waters and decide for ourselves and our respective families the best way to move forward. Meet Our Experts: Dr. James H. Anderson Jr. and Tom Santelli Dr. James H. Anderson Jr. Carmel resident James “Andy” H. Anderson Jr., M.D., FFPM, FACE, is a world-renowned endocrinologist, diabetologist and retired lieutenant colonel in the U.S. Army Medical Corps. Dr. Anderson is also the medical director for PTS Diagnostics, Inc., a U.S.-based manufacturer of point-of-care diagnostic products that is based in Boone County. Dr. Anderson graced our cover (November 2014) when he weighed in on the topic of the infamous Ebola virus and on his experience with infectious d Throughout his tenure at Fort Detrick, Dr. Anderson worked on the containment procedures and the academic study of anything that could have been considered a bioagent such as anthrax, botulism, etc. He studied what the bacteria or virus did, how it replicated and how it could be transferred. Then he began his research on developing a treatment or vaccine. The book “Hot Zone” by Richard Preston came out and was followed by the movie “Outbreak,” which featured Dustin Hoffman who played Dr. Anderson’s role at Fort Detrick. It was a fictional story that was inspired by the procedures and processes that were implemented at Fort Detrick. Tom Santelli Zionsville resident Tom Santelli serves on the Boone County Commissioners, representing District 1. Santelli has led the sales and marketing for Temple-Inland; led the research and development for Weyerhaeuser, Georgia-Pacific, Great Northern Nekoosa and Owens-Illinois; served as the budget director in corporate planning for Fortune 100 companies; engineered and built state-of-the-art research and manufacturing centers; developed a number of groundbreaking products and services and served as a director for environmental and public affairs working in Washington, D.C. Santelli holds graduate degrees in business and science, including a degree in biochemistry and an MBA from Bowling Green State University. Early in his career, he worked on creating the plasma digital screen that was an integral part of the development of the ATM machine, along with several other patented inventions. Santelli was contracted by the U.S. Post Office to develop their self-closing mailers and packages and was recruited by USPS to develop a system that kills anthrax and other bacteria to prevent the spread of disease through the mail. In 2004, Santelli started his company, The Technology Group, that focuses on creating new products and developing solutions to make our lives, homes, and consumables more sustainable. Novel Coronavirus (COVID-19) 101: According to Dr. Anderson, “The virus that causes COVID-19 is a single-strand ribonucleic acid (RNA) virus. Single-strand RNA viruses frequently mutate. A more complex virus or DNA virus that has two strands of genetic material can often repair itself. A single-stranded cannot. The two things to worry about in mutation is: Does it make the virus more deadly and does it make the virus easier to spread? This is obviously a new strain of the coronavirus , and there is still a lot that we don’t know about it. If you look at coronaviruses, there are more than 30 coronaviruses, and there are seven that affect humans, 4 give people, essentially, the common cold or flu-like symptoms. And people most always recover from these with no problem. Three are more serious causing SARS, MERS and COVID-19.” Dr. Anderson compared a virus mutation to having fraternal twins. “Scientifically, you can tell the difference, but it’s sort of like having twins where one has blond hair and the other has red—they’re not that different from one another.” Santelli cited an online article published by Healthline.com stating there are 14 identified strains and growing (www.healthline.com/health-news/what-to-know-about-mutation-and-covid-19#More-contagious?-). “Some of the most recent are even more infectious,” Santelli said. “The infection rate is given in the RO factor: For the flu, it’s 1.3, and for the novel coronavirus, it’s R3.0 to R6.0. Depending on the strain, it’s up to three to six times more infectious. The mutation rate of the coronavirus occurs at a rate 40,000 times faster than the human genome. While there are at least three different mutations of the coronavirus as identified, for example, the New York COVID-19 infection is tied to the virus RNA genome established in Europe. The better discussion is around “antigenic drift,” which is what is happening. We will over time see different variations of the COVID-19 virus. This is a discussion around what it means: https://www.cdc.gov/flu/about/viruses/change.htm.” Social Distancing Is Not Just a Buzz Phrase—It Saves Lives The Centers for Disease Control and Prevention (CDC) has repeatedly stated that “Limiting face-to-face contact with others is the best way to reduce the spread of coronavirus disease 2019 (COVID-19).” Dr. Anderson agreed with the CDC and added, “Hand-washing and social distancing is still important. What we as individuals can do is to take care of ourselves and be socially responsible for the benefit of our neighbors and the rest of the population. The obvious danger is that there are certain people who are more susceptible to severe consequences of the virus, and those have been identified as the elderly, people with significant medical problems and who are immunologically compromised.” Another potential threat caused by COVID-19, according to Dr. Anderson, would be to overwhelm the health care system—NYC being a devastating example. “All this talk about ‘peaks’ and ‘flattening the curve’ is really to allow the ability of the health care resources that we have right now to handle the medical needs of all the patients who require hospitalization and/or significant medical treatment.” People are still being encouraged to get outdoors and enjoy the sun and fresh air, so as long as they continue practice social-distancing guidelines. “Viruses don’t do well if they are dried out,” Dr. Anderson explained. “The virus will live as long as there’s moisture around it, but if it gets completely dried out, the virus dies. If you’re out in the sunshine, there is little chance that there’s any virus out there unless there happens to be somebody who is actively infected standing close to you, sneezing and coughing in the air.” Additionally, there is a greater chance of infection if someone is asymptomatic and is breathing directly in your face, which is why Dr. Anderson and Santelli encourage everyone who is out in public to wear face masks. “The CDC talks about face masks and using cloth face masks,” Santelli said. “While a cloth face mask may not give you 100% protection against breathing in the virus, it's a positive tool to prevent transmission from the standpoint of the individual who's infected giving the virus to somebody else. The other thing about wearing a mask is that it helps you remember to not touch your face.” Santelli added, “We know that if somebody sneezes or coughs, the virus can travel 14 feet within 45 seconds. We also know that it's going to remain suspended in the air as an atomized mist for four to six hours. When you go into a hospital room to clean it, you typically wait four to six hours for the virus to settle out.” A Global Race for a Vaccine and Antiviral Treatments While the global population may be split between the at-risk population and the general population, and between those who continue to self-isolate and those who have resumed their day-to-day activities within this “new normal” chapter in human history, one thing is certain: We all want effective vaccines, antivirals and pharmaceutical treatments to fight against this insidious virus—COVID-19. “The CDC has current projections of 200,000 to 400,000 deaths by August,” Santelli stated. “They’re using the University of Washington’s model to make some of their predictions. Drilling back to this past flu season—which was one of the worst on record—we had 161 million people vaccinated and approximately 17.6 million got the flu. We had a fairly good effectivity rate from the vaccine, but according to the CDC, it was only 47% effective because we’re trying to guess which mutations we’re going to deal with.” Santelli continued, “Now, this SARS virus has a transmissibility three to six times greater than the typical flu, which is why the models are predicting up to 400,000 deaths through August. Also, it’s kind of hard to slice and dice the comorbidities. Additionally, there is no post-mortem test for COVID-19 that is approved by the CDC, so if someone dies without having been tested , their death is not necessarily recorded as death by COVID-19.” As our nation continues to reopen and kickstart the economy back to pre-pandemic earnings, the debate also continues on how to handle major sporting and entertainment events and when to send our nation’s children back to school. Dr. Anderson cautions people that the pandemic is far from over and we need to continue social distancing practices until a vaccine is available. “You shouldn’t give up any of the things that you’re used to doing, but there isn’t going to be an alarm bell that goes off on the Fourth of July indicating that ‘Everything is back to normal now.’ Just like Ebola—which has been around and has occasional reoccurrences—this virus will be around for a long time. Eventually, there will be a vaccine. There are several different companies working on vaccines and/or therapies. Now, will everybody get the vaccine when one has been developed? Probably not. There will be the anti-vaxxers who don’t want it, just like there are various people out there who don’t want to observe social distancing. If we go with the science, we can control , but we are 14 to 20 months out because we’ve already allowed the virus to mutate. It’s going to come back like the H1N1—in a different variation. Like the flu vaccine, we’re going to guess which variations of that RNA virus strand we’re dealing with and try to come up with a multipart or a single vaccine.” Santelli added, “The question that keeps coming up is if you’re exposed to and get it, are you comprised or are you immunized? Baylor University’s Dr. Peter Hotez—who has done a lot of the original research on coronaviruses and the vaccines that they have developed—has reported that the people that were subject to a SARS infection actually fared worse than those that did not get the vaccine. Another big question is why those who keep exposing themselves to , such as those in the medical profession who have tested positive and are otherwise healthy, end up dying? Is it because the virus overloads the immune system and then the immune system gets to the point where it starts to attack organs and your blood chemistry and things like that?” Mitigating the Transporting of COVID-19 “You have read people state that the virus lives only 24 hours on paper and 72 hours on plastic,” Santelli said. “In my career I have grown viruses, mold, mildew fungi, fungus and bacteria—some good, some not so good—focusing on air, water, environmental quality, food and workplace safety. I ran a test on a typical transport media for viruses, bacteria, mold and mildew. This is a four-week uninoculated culture from a composition of glass, plastic, metal and paper. Rather than ‘bugs’ dying, these surfaces become an excellent transport media. This virus can transport through HVAC systems and certainly in the contained atmosphere in an airplane or cruise ship. There’s a lot of good information and misinformation being circulated in the media. Your shoes are one of the best transport media.” Santelli added, “Imagine if you got a paper ballot, and you're filling it out and you cough on it. Then you fold the ballot and you put it in the envelope. That virus is going to go right to wherever you mailed it, and that's one of my areas of expertise. While working on the 2001 anthrax with the USPS mail, we had to create an outer surface and an inner surface of the envelope that would kill anthrax but also make it safe for anybody handling it. We can mitigate mold, mildew, fungus and bacteria with loads of 50 million-plus on paper surfaces and render it safe within 60 minutes, so my question is, shouldn’t we be doing everything we can to mitigate this virus?” We asked Santelli, since he is one of Boone County’s three commissioners, if he feels that the county is ready for its reopening, but more importantly, is it prepared for a second surge? “Our position in Boone County is that we will continue to communicate the guidelines to the best of our ability,” Santelli emphasized. “We’re going to depend on the individual citizens and constituents to comply with those guidelines. We’re at stage two going on stage three, but there’s a lot of people who are acting as if we’re at stage five. The sheriff is testing his department on an ongoing basis because his department is housed with the county’s jail, and we have responsibilities to our employees and to the people we bring in there. The county fairgrounds and Lebanon High School gym are staged should we need additional facilities.” Santelli concluded, “If we look at St. Louis and Philadelphia , one group kept exposing themselves and another group took a much more conscious effort to avoid big groups. We were at no more than a group of 10 and now we are at 25. The reaction across the nation is that we can’t stop the economic engine because the cure is worse than the disease in this case, and the problem that we face is we have protocol in place and will people continue to try to follow the recommended CDC guidelines?”

COVID-19: Dr. James H. Anderson Jr. and Tom Santelli Weigh on the Facts

COVID-19: Dr. James H. Anderson Jr. and Tom Santelli Weigh on the Facts