HJAR May/Jun 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2020 11 Editor Our healthcare system seems to have been caught flat-footed by the demand for protective gear, and the sup- ply chain has proven fragile. How could this have been prevented? Jennifer A. Dillaha, MD I think one of the important lessons here is that pandemic planning needs to be part of the public health system that receives the appropriate resources for staff and personnel to carry out planning functions. Had those resources been available in a consistent manner over the years, perhaps this could have been prevented. Editor Are we making a difference with stay at home orders? What do you think will happen when those orders end? Dillaha I can speak from a point of view in Arkansas, and we do not have stay at home orders here at present, but we do have inter- ventions for addressing social distancing. In central Arkansas and the city of Little Rock, as well as around the state, under the guidance of the governor, restaurants and schools have been closed, and education has been switched to online. So, there have been some initiatives that support social distancing, and my understanding, based on what happened with influenza inArkan- sas at the time, is that after these interven- tions were put into place, we saw a drop off in the intensity of influenza identified around the state. This leads me to believe it is also having an effect on the spread of the COVID-19 virus, which spreads in a way similar to influenza. We have not had the availability of testing around the state to be able to do widespread surveillance as we do with influenza, but my understanding, based on what happened with influenza, is that COVID-19 is likely to be similar. When we get to the point where we want to lessen the restrictions related to social distancing, then I think it will be even more important to have the availability of widespread test- ing so we will have a better understanding of the prevalence of COVID-19 in commu- nities around the state. This will enable us to be more timely with removing some of see the spread of this virus from time to time in various populations, depending on the overall immunity of the population, so I think having a vaccine is going to be very important. Editor Are there some who have a natural immunity to the COVID-19 virus? Dillaha I would say no. Editor Once recovered from COVID-19, is a patient immune? Dillaha They are likely immune for the time being. How long that immunity endures is unknown. Other coronaviruses do not promote a lasting immunity, so people can catch the common cold coronaviruses more than once in their lifetime. Editor What do you think is the single most important thing being done right now to combat COVID-19? Dillaha In the long term, developing a vac- cine. In the short term, the important things being done are the public health interven- tions to slow the spread of the disease. those social distancing restrictions. I’mhop- ing it will go well, but of course this is a new disease, and we don’t know whether it will have seasonality to it or not—I’m thinking it probably won’t. We also don’t know if it will behave as other pandemics, such as flu pandemics that had peaks at different times of the year, so we’ll just have to see. Editor Do you think this outbreak of SARS- CoV-2 is a one-time only occurrence, sea- sonal, or episodic? Dillaha I believe it is unknown. Influenza is seasonal, and some people think it has to do with the temperature, and other people think it has to do with the fact that school is not in session in the summer. We’ll have to see if this new virus behaves similarly, but there are countries where it is spreading and it’s not behaving like flu, so we’ll have to watch. We know there are other corona- viruses that cause the common cold and spread during the winter time mostly, but not totally. People do not develop lasting immunity for these viruses, so it is possible humans will not develop lasting immunity to the virus that causes COVID-19. If that is the case, then I think we will continue to