Dr. Michael Saag is one of the nation’s finest authorities on the coronavirus– not just since he’s researched infections for more than three years, but also since he just recently recuperated from the health problem himself.
Saag has actually published research on HIV/AIDS dating back to the 1980 s. He now acts as the associate dean for worldwide health at the University of Alabama at Birmingham, along with the director of UAB’s Center for AIDS Research Study.
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He was identified with COVID-19 just over one month back, on March16 He explained the disease as a “horror” that consisted of fever, muscle aches, fatigue and trouble believing.
Now completely recovered, Saag, a contagious illness physician, treats other COVID-19 patients at a clinic in Birmingham.
NBC News spoke to Saag recently about his experience with the health problem, which he recuperated from without requiring to be hospitalized. The conversation has been gently modified for length and clarity.
NBC News: Talk about your individual experience with COVID-19 How did the illness impact you?
Saag: It’s been an interesting trip; a frightening roller coaster, and every night is dreadful. The mornings are much better, but it sort of teases folks– myself included– into thinking that it’s disappearing. And after that, boom,! It comes right back. For me, that went on for 8 days in a row.
I would sit awake, counting the minutes until early morning nearly, questioning if my breathing was going to get even worse and I ‘d end up on a ventilator.
The nights are so bad, since as a doctor, I know what can take place. Therefore I would sit awake, counting the minutes till morning nearly, questioning if my breathing was going to get worse and I ‘d wind up on a ventilator. That was the horror of it.
NBC News: What was your treatment strategy?
Saag: We don’t have a tested treatment and I think that’s vital to understand. It mentions how ruined we have actually ended up being in the world of medicine. We have many treatments for a lot of disorders that we simply presume that when something appears, we can manage this.
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But the reason we can manage it for other illness is that we’ve had time to do randomized trials that we have not had time to do with COVID. In my case, after the 2nd night of horror I’ll call it, I was extremely concerned that I was heading the wrong instructions. Which’s about the time a study came out that suggested utilizing hydroxychloroquine with azithromycin.
So I called 10 colleague experts and said, ‘What do you think?’ They stated, ‘Well, go ahead and try it.’ I did. I can’t truly inform you it helped or hurt. In retrospection, now that I have actually been able to look into it a little bit more, I’m a bit embarrassed of myself, because I could have put myself into damage’s method terms of sudden death. That can occur when you utilize those two particular drugs together, since they can trigger a fatal arrhythmia, and I was not being kept an eye on properly.
The take-home point is I completely get why someone who’s that sick would want something, because doing nothing is extremely, very tough.
On the other hand, we really do require randomized regulated trials to inform us the truth of what the drug program does or does not do, and what its safety profile is. Till we have that, we’re really trying to fly a plane in fog without instruments.
NBC News: You have actually not only been contaminated yourself, you’re treating patients at a COVID clinic. What more are you learning more about the symptoms and how this disease is acting in people?
Saag: It’s distinct. The infection is not like the influenza that hits you at one time. These symptoms sort of gradually approach on folks, and after that it crescendos.
For some people, they may not have symptoms at all or they could clear it in five days. But for the majority of people, by five to 10 days, that’s when symptoms heighten, and are generally worse at night: fever, muscle pains, fatigue, headache.
Loss of sense of odor is sort of a distinct sign. It’s not present in everybody. However if I have a client call me and say, ‘I do not feel excellent and I have actually lost my sense of smell’– till proven otherwise, they have COVID, there’s no concern about it.
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NBC News: It’s now been shown the virus can have a neurologic effect. Did you have those type of symptoms?
Saag: There’s no concern that it clouds cognition. At night, I was not believing clearly. I can’t say I was delirious, however I had to focus hard when talking. And I had to focus hard when thinking of, for instance, addressing an e-mail, which I learned not to do when I didn’t feel well.
NBC News: What mechanism do you think causes those cognitive deficits?
Saag: I’m quite positive it’s swelling. It’s our immune system that’s strongly attacking the infection, and the by-product of that battle is causing civilian casualties. It’s friendly fire. It’s our immune system going haywire attempting to toss everything at this infection. But in the course of doing that, it’s causing damage inadvertently to other tissues.
To get a bit more technical, when the immune system reacts to a pathogen, state this virus, [the immune system] recognizes that it’s under attack. And it fights by hiring other cells of the immune system and it does that by releasing chemicals called cytokines.
These cytokines can be launched in prodigious amounts. And when they are released, that’s what causes the signs of the infection. And the cytokines are released into the body. And those are the important things that in my viewpoint, are triggering the other symptoms such as cognitive dysfunction, neurologic sequela, heart difficulty, kidney failure, perhaps even the diarrhea that we see.
And it’s not till those cytokines return under control, that the body starts to heal.
NBC News: What do we know about resistance and the length of time might that last?
Saag: Well, I am connected to a lot of people in research labs, so I sent out blood off to numerous locations. I’ve been notified that I have high levels of antibody, and those antibodies seem to be neutralizing antibodies, which indicates that they can attack the infection, and protect cells and tissue culture from ending up being contaminated.
But the question still remains: how does that equate into true security should I be re-exposed to the infection?
Based on other viruses that we encounter, like measles or mumps, the proof is quite clear that kind of resistance is protective. In other infections, such as liver disease C, individuals can be reinfected. The same thing holds true for infections like dengue, which is a tropical infection.
So it’s not 100 percent clear with coronavirus, however my personal bet is that the resistance will be protective.
If that holds true, then that’s excellent news due to the fact that individuals who have actually had the infection are protected, and that’s going to assist us get out of this in the long run. But more notably, it means that a vaccine can work.
A vaccine will be a game changer. That will enable us to think of getting back to “regular life” if it’s offered– extensively available– and efficient.
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