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A local expert discusses COVID-19

Will there be a second wave and what can we do?

Timothy Murphy, MD, director of UB's Clinical and Translational Science Institute


Timothy F. Murphy, MD, is an infectious diseases physician scientist, a SUNY Distinguished Professor, director of the University at Buffalo’s Clinical and Translational Science Institute, and Senior Associate Dean for Clinical and Translational Research at the Jacobs School of Medicine and Biomedical Sciences. We talked to him about COVID-19 and what we can expect as the first wave of the pandemic begins to slow down across the US.


Spree: What's your main role in the area of WNY COVID-19 response?

Timothy Murphy: As director of the UB Clinical and Translational  Science Institute, my role is to help coordinate and provide support to perform research that is aimed to improve the health of our community and the nation. We are placing a high priority on bringing clinical trials of new and potentially promising COVID-19 treatments to make them available to people in the Buffalo area while also advancing the field of identifying effective treatments. Our clinical partners include Kaleida, Erie County Medical Center, Roswell Park and the Catholic Heath System.


This global pandemic is unprecedented in our lifetime. During the onset of the HIV-AIDS epidemic, I took care of patients before there was any effective treatment and the disease was essentially a death sentence. Over the following years, I had the opportunity to offer increasingly effective treatments as they were developed, to the point where we now have therapies that allow people with HIV to live long productive lives. This was a direct result of a robust national research effort to understand how HIV causes disease in humans and in developing and testing new treatments. We are now at the beginning of that journey with COVID-19. I am optimistic that new therapies and vaccines will be developed in the next year or so for COVID-19.


We're getting new reports on COVID-19—especially on new symptoms—on a daily, maybe hourly basis. How to sift through it all and keep the anxiety levels down?

This is a problem that can cause anxiety for many people. My advice is to stay informed but don’t overdo it. Be especially skeptical of what you hear on social media. I suggest three sources for reliable up-to-date information
Erie County Department of Health  
New York State Department of Health 
US Center for Disease Control 
These give you local, state-wide and national perspectives.


How likely do you think a second wave is? There is talk of a recurrence in the fall.

I am struck by how difficult it has been for the experts to predict how this pandemic will unfold. Initial forecasts regarding the likely number of cases locally and nationally have thus far been inaccurate. We will get better as we learn more about the virus and its characteristics. Either way, it is critical that we are prepared for a second wave.


So, with that caveat about making predictions, knowing what we know about how respiratory viruses behave, it seems likely we will see a second wave. For example, the 1918-19 influenza pandemic had three waves. However, we are in a very different place compared to two months ago with regard to our ability to detect disease and respond accordingly if there is a second wave. That ability to track disease and take the necessary steps to control and mitigate spread in a proactive way will reduce the impact of a second wave.


What is your assessment of how WNY hospitals are dealing with COVID? 

Our entire regional healthcare enterprise has shown a tremendous commitment to working together to meet the pressing needs of patients during this pandemic. Collectively, Kaleida, the Catholic Health System, and Erie County Medical Center have increased healthcare capacity enormously, particularly in being able to care for critically ill patients.  Healthcare workers have not just continued their usual efforts, but have volunteered for extra duty in response to the need—including nurses, healthcare aides, physicians, pharmacists, dietary workers, custodial workers, and many others. They are putting themselves at risk for the benefit of all of us.


The official word is that WNY's peak may still be a couple weeks off, though it looks like it might be plateauing now. Your view?

As Yogi Berra said, it’s difficult to make predictions, especially about the future. This is an especially eloquent statement when talking about the coronavirus pandemic. Through the tremendous efforts of the community in social distancing, it looks like we have reached a plateau in the important indicators—hospitalizations, ICU admissions, intubations, and deaths. My view is that our behavior as social distancing measures are gradually loosened will be the most important factor as to whether COVID-19 cases increase in the coming weeks and months.


What are the most important precautions that WNY households should take?

The key precautions now are a vigilant commitment to social distancing and respiratory hygiene. Social distancing has literally saved lives by reducing the number of people who have become infected.


From a practical standpoint, social distancing means staying home as much as possible, including home delivery services and online shopping services offered by grocery stores, pharmacies, and other essential services. If for some reason you must go out, then wear a mask or face covering and keep a safe distance of at least six feet from others. It also means not getting together with people who live outside your home.


Respiratory hygiene practices that we should all be doing include washing your hands often with soap and water for twenty seconds. If soap and water are not available, use an alcohol-based hand sanitizer. You should avoid touching your eyes, nose, and mouth. My view is this is especially important…and difficult. I never realized how itchy my face seems to be all the time until I made the effort to avoid touching it! Clean and disinfect frequently touched surfaces and objects (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks) using household disinfectants.


What's the good news?

Recognizing the tragedy of lives lost and the impact that this pandemic is having on peoples’ lives, the good news is that without social distancing and without the incredible efforts of our healthcare workforce, it would be a lot worse. The fact that social distancing was implemented in WNY before disease was widespread was critical in “flattening the curve” and keeping the number of infections and the number deaths far below initial forecasts.


What's the bad news?

The bad news is that deaths from COVID-19 infection are disproportionately affecting African American communities. In the city of Buffalo, about sixty percent of deaths are of African Americans while the city’s overall population is thirty-nine percent African American. This striking disparity is a direct result of the high incidence in African American communities of underlying disorders that predispose to more serious outcomes from coronavirus infection, including heart disease, diabetes, and underlying lung disease, including asthma, compared to the white population in Buffalo. Thus, the coronavirus pandemic severely exacerbates existing and alarming health disparities along racial lines.


If there is a silver lining, I hope this disturbing toll that coronavirus is taking on African American communities will raise the local and national awareness on this critical problem. These disparities existed before the pandemic and are largely due to what are called the social determinants of health, which include poverty, underdeveloped neighborhoods, high unemployment, low property values, poor access to public transportation, absence of grocery stores, lead contamination in homes, failing schools, and poor access to healthcare. A robust community-wide effort is needed to begin to address these problems that collectively have a devastating impact on the health and well-being of east side and west side communities in Buffalo.


How do you personally cope with this in your life? How do you keep calm and find possibilities for happiness?

My sons and their families live nearby. The most difficult part of social distancing for me is not being able to do our normal activities with them and our grandchildren, who range in age from one year through eight years. My wife and I use video conferencing for visits and do brief socially distanced visits in the driveway. Connecting with them, even at a distance, helps me a lot.


I have also been committed to regular exercise for a long time. I find that regular workouts and frequent walks are especially helpful for my outlook and ability to deal with these challenging times.


Finally, I try to find the small victories to celebrate in my work. Contributing to offering new treatments to patients in this area through clinical trials and advancing our understanding of COVID-19 with new research are important steps on the path to finding effective ways to treat and prevent these infections and save lives. There are many talented researchers and professionals in the area committed to that goal and I am privileged to be part of that effort.


Spree thanks Dr. Murphy for finding the time to answer our questioins. To learn more about him and his work, follow the links given at the beginning of this interview.


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