Follow the science

Infirmary Health doctors peel back mysteries of COVID-19, warn against school openings and say a universal vaccine is our only hope


COVID-19 patients who receive plasma from those who have recovered from the disease are healing faster, said Dr. Furhan Yunus, of Infirmary Health.

Read that again and try not to get excited. It is exciting. It is fantastic news.


Preliminary studies show this is happening. And while promising, those of us waiting for answers at the gates of laboratories and hospitals around the nation will have to continue to stand by and hold our breath.

The COVID-19 pandemic has introduced real-time virus hunting to people who last thought about the scientific process in eighth grade. It’s painstakingly lengthy, extraordinarily precise and can be utterly confusing as results yield both hope and despair each step of the way.   

At Thomas Hospital, in Fairhope, Yunus is one of a handful of doctors who are tasked with treating COVID-19 patients and untangling the virus.

As Director of Infirmary Cancer Care, Yunus normally spends his days with patients who have blood disorders or cancer of the blood. Now, he helps to care for one of the largest Covid-19 caseloads in the state.

Even as scientists unravel new information about the disease each day, Yunus said one thing remains clear: without a unified national response the number of cases will continue to grow and kill.

Hunting the virus

Infirmary Health has tended to the largest number of COVID-19 patients in the southern half of Alabama. Last week Yunus said 15 percent of patients at Thomas Hospital were infected with the virus, a number that reflects an ever changing snapshot in time as patients come and go, recover and succumb to the disease.

For physicians like Yunus, the virus offers an opportunity for the public to watch science unfold as doctors race to find out what the virus is, why it is and how to stop it.

There are starts and stops. Information is released and then recalled. It’s frustrating and confusing but long-time researchers know this is how science works.

Still, Yunus says modern man has fared better than his counterparts would have just a generation ago because of the ability to quickly share information globally.

“Within six months there are at least 8 million people around world that have gotten infected and we are coming close to 1 million people dying from the disease worldwide,” he said. “This has produced a tremendous amount of need for better and faster understanding of this disease and the reason we have been able to do things faster than usual is because of technology.”

Yunus said researchers have been able to collaborate and share information within minutes.

Faster information, however, has its drawbacks.

Yunus also said researchers need to be more cautious with successful preliminary results.

“Whatever we learn we have to be trying to use as cautiously as possible and try to validate it. That sometimes takes time,” he said.

For example, doctors who treated Ebola, a deadly virus primarily found in Africa, injected plasma from those who had recovered from the disease into patients suffering from it. The injections helped speed their recovery.

Based on that knowledge, researchers quickly began doing the same for COVID-19 sufferers. Plasma from recovered COVID-19 patients was injected into those still sick with the disease.

Multiple national studies were implemented, including one at Infirmary Health. Yunus said doctors there have treated nearly 250 patients with the plasma, and nationwide nearly 7,000 patients have received the treatment.

So far, he said there is a lot of indirect and anecdotal evidence that the plasma helps speed Covid-19 recovery. It is great information, but not quite enough to declare victory over the virus.

“To finally say without question that it works you need to do trials where some patients get the plasma and others get a placebo,” he said. “Those studies are ongoing. We believe it works but we have to prove it.”

One thing they have proven: the plasma causes no harmful side effects.

“So there is no harm in giving it. How much it helps, we will know soon,” Yunus said.

What we’ve learned

As scientists around the globe race to understand COVID-19, Yunus said there are some facts that they have learned are true. These include:

-          This is not your regular flu; this is a much more contagious illness.

-          It primarily strikes through droplets that come out of patient’s mouth and nose while infected. Those droplets hang around in air up to 12 feet from the person who is infected.

-          Generally one patient who has COVID-19 can infect 2 – 3 others.

-          While the disease is mild in some it is very severe in others. Yunus said doctors are still “sorting out which people get the mild version vs which get the severe disease.”

-          There have been many more deaths in the minority population, both African American and Latino.

-          People who have illnesses like emphysema, kidney or heart disease, have a much higher risk of severe COVID-19 infection.

But with a high recovery rate touted on every conspiracy website, why is COVID-19 so dangerous?

The answer is in the numbers.

So far nearly 150,000 people in the U.S. have died from COVID-19, in just five months. Yunus said when that number is annualized, meaning the rate of death in four months is calculated to determine the rate of COVID-19 deaths in all of 2020, and the U.S. will easily reach 700,000 deaths or more by New Year’s Eve.

The staggering death toll is not the only problem.  

For the hundreds of thousands that the disease leaves alive, even those who appear asymptomatic, the virus remains inside the body, waiting to strike.

“What really is of major concern is the damage this infection will cause to the body’s organs, especially younger patients who are going to live with this for 40-50 years,” Yunus said.

“If you have lung, kidney, or heart damage from COVID, and you don’t die, you are going to get sick and live with this disability for a very long period of time,” he said. “Not only will it be suffering for you and your family it will be a huge strain on the health care system and the financial system of this country which we are not going to be able to manage.”

How to fight it

Yunus said while viral memes online spread false information about the disease, doctors treating it largely agree that the number of cases have actually been underestimated - by a staggering 10 – 12 people for every one person who received an official positive test result.

Roughly 35 percent of positive cases are undiagnosed. Those asymptomatic individuals go about their day, continuing to spread the disease unknowingly.

Yunus said doctors worldwide have found that the best way to minimize infection is to shut down and keep people at home.

“We did that for about four weeks and it worked and we started to see the infection rate went down,” he said. “However some parts of the country started reopening faster than we should have and it has come roaring back.”

In nations like South Korea and New Zealand shut downs were all encompassing. Masks were mandatory and the spread, and the death rate, was kept at a minimum. Yunus points to nations who followed strict guidelines as examples of how to eradicate the disease. 

“A slow reopening after shut down is the most effective way of getting rid of this,” he said. “Social distancing and uniformly wearing a mask are other things we need to do.”

The first day of school in Baldwin County on Aug. 12, Yunus said, could mark a perilous time for those at risk of serious infection.

“We’ve also learned from other countries that the reopening of schools is going to be extremely dangerous,” Yunus said.

Should Baldwin County schools re-open for in-person instruction?

Yunus said, “No.”

“I would tell the superintendent they should only do remote learning at this time. We are in a surge. That is not going to go away in four to five weeks. In fact, unless we have very dramatic orders to shut down it will be highly dangerous and frankly highly irresponsible to send all children to school physically, fully understanding that the flip side of the coin is not very good either.

“But, when it is a matter of life and death then I think we will have to make the best of all the bad options we have. Until the virus has been suppressed in our community, physical schooling is very dangerous and will put our children and rest of community at great harm.”

Busting the conspiracy theories

With the numbers clearly backing doctors’ concerns, why are people still brushing off COVID-19 as nothing more than a flu? Yunus said politics is to blame.

“I think the real reason people are not paying that close attention to this has to do with, unfortunately, the politicizing of this pandemic. But the facts cannot be denied. There are 2 million infected Americans and almost 5 percent of patients getting infected are dying.

“With the regular flu we have only .1 percent of patients die. You have a 500 times higher chance of dying from COVID than from regular flu. People follow information and there is information all around us but unfortunately half of the information is basically false and people do fall prey for some of these conspiracy theories,” he said.

Yunus said he has had ill patients who still refused to believe in the severity of COVID-19. The problem is that illness impacts the community, not just the individual patient.

“If they were only making decisions for themselves and it only affected them, it becomes a personal choice and a matter of personal freedom. The problem is no one has the personal freedom to go around infecting the rest of the community and it is putting a strain on everything including the healthcare system,” Yunus said.

 I’ve told people, ‘if you want to make this choice you certainly can but morally it is the wrong thing to do.

“The whole argument and discussion about personal freedom and choice is sort of a false discussion,” he said. “We don’t allow people to drink alcohol and drive, because they will kill someone else. I am all for us having maximum freedom but I am not willing and not in favor of letting other people take my freedom away by making me or my community sick.”

Developing a vaccine

Had the U.S. ignored the virus as it came ashore and continued life without shutdowns or mask requirements, Yunus said the nation would easily see over a million Americans dead from COVID-19.

If communities continue to refute efforts to contain the disease, the U.S. could still suffer a staggering number of dead.

“A lot more people will die. We will either have to accept it and surrender to the virus or shut down again until we get a vaccination or other effective treatment,” he said.

That vaccine is eight to 12 months away, at the earliest.

And there is no guarantee it will work.

Yunus said initially scientists noticed that the virus was changing as it spread though its rate of infection did not. That was good news.

Recently, however, scientists have discovered a strain in Europe that is more virulent and believed to be more dangerous. When viruses change, the vaccines designed to control them become obsolete.

If the vaccine is a success, the next step is convincing everyone to take it.

“If we have a very effective, long-term vaccine this can go away. But it can only go away if we vaccinate everyone. If 15 – 20 percent refuses then that population will continue to spread it,” Yunus said.

“Until we all come together as physicians, politicians and government and say the same thing with one voice unfortunately we are not going to be able to fight this as other countries have where the people have believed in the danger and the severity of the disease,” he said.