BCMS Medical Record Fall 2020 - 26

M e d i c a l R ec o r d F e a t u r e

A College Student's Perspective
on COVID-19 in Berks County
by Michael Silver, Berks County Medical Society 2020 Student Intern
Advisors: Raymond C. Truex Jr., MD, FAANS, FACS, and D. Michael Baxter, MD

T

he Coronavirus Disease 2019 (COVID-19) pandemic is
widespread. Worldwide, over 700,000 people have died. In
the United States, more than 5 million have been confirmed
infected (1). In order to address public health and safety, we
have had to change the way we live our daily lives. Quarantines,
being socially distant, and wearing masks in public spaces have
become the "new normal." These public health measures, although
objectionable to some, are critical to curb the spread of the novel
Coronavirus (SARS-COV-2).
Generating public support for the proper adherence to public
health protocols is a high priority challenge. Over the summer,
through my internship with the Berks County Medical Society,
I have had the opportunity to review Berks County's response
to the spread of the virus. In addition, I have attempted to
understand the specific challenges that our county faces, as well as
to consider what the future might hold for addressing the spread of
COVID-19.
Since the beginning of the COVID-19 outbreak in Berks
County 5,535 people have been confirmed infected with the virus,
and 374 of those people have died. These statistics give the county
a case fatality rate of nearly 7% for COVID-19. (2) However, these
statistics can be slightly misleading in that there are likely a greater
number of people who have the virus, are asymptomatic, and have
not been tested. Additionally, the number of deaths recorded might
also be inaccurate due to coroner reports attributing causes of
death to other conditions or using inaccurate tests on the deceased.
Nevertheless, these numbers are significant because they show that
COVID-19 has seriously affected the health of our community and
will continue to do so unless it is controlled.
In order to address this pandemic, it is critical to understand
some of its basic characteristics. SARS-COV-2 is a novel
Coronavirus which has major viral shedding in the upper
respiratory tracts of its hosts. This means that the virus can easily
spread in infected individuals through aerosolized droplets from
respiration, coughing or sneezing. When an individual becomes
infected with the virus, they can begin spreading it 2 to 7 days
after initial infection. However, the specifics of how infectious an
infected individual is are still uncertain. There has been evidence
to support the claim that asymptomatic, pre-symptomatic, and
symptomatic individuals are all infectious.

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www.berkscms.org

The attempt to quantify a virus's rate of infection is known
as R0. SARS-COV-2 has been determined to have an R0 value
between 2.2 and 2.7, meaning that on average each infected
individual will infect at least 2 other people. Additionally, the R0
value for SARS-COV-2 has proven to have a very low variance,
meaning that a high percentage of people who become infected
will end up transmitting the disease. This low variance shows that
in order to prevent outbreaks of the virus in new areas a very high
percentage of infected individuals will have to be stopped from
spreading the infection. (3)
The effort to stop the spread of SARS-COV-2 in Berks County
focuses on 3 major steps. First, the county established a contract
with the Co-County Wellness Center to create a contact tracing
system. This million-dollar contract provides contact tracing
services for a year. However, participation in this program is not
mandatory and the notification of contacts is limited by individual
reporting and the time it takes for a positive test result to be
determined. Nevertheless, this system can provide much needed
guidance to willing participants.
Next the county formed The Berks County COVID-19
Medical Advisory Panel in order to provide guidance to the
County commissioners on how best to respond to the public health
crisis caused by SARS-COV-2. The panel has the critical role of
understanding the unique micro-environments of transmission that
exist within the county and giving advice on how best to manage
the risk for infection in these environments. This panel must weigh
the potential risk versus reward for transmission vectors such as
schools, restaurants, and businesses.
Third, the county has created the "Do Your Part - Stop the
Spread" (DYP-STS) campaign to increase public awareness about
the importance of continuing to follow public health guidelines.
This measure is arguably the most important step by the county
to address the pandemic at a local level. Since the key methods of
controlling the virus rely upon the public following public health
guidelines, making information readily available is critical. The
DYP-STS campaign emphasizes the importance of following public
health guidelines to protect not only the individual, but the most
susceptible members of our community from the virus.
The DYP-STS campaign is a promising initiative but,
unfortunately, I did not hear about this campaign through
http://www.berkscms.org
BCMS Medical Record Fall 2020

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