COVID-19: Dr. Neil Kay on Managing Re-Entry: When Will it be Safe for Patients with CLL?

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COVID-19: Dr. Neil Kay on Managing Re-Entry: When Will it be Safe for Patients with CLL?

December 14, 2020

This content was current as of the date it was released. In science and medicine, information is constantly changing and may become out-of-date as new data emerge.

I talked to Dr. Neil Kay of Mayo Clinic, Rochester, MN on how he decides about the safety of his CLL patients leaving “sheltering in place” and re-entering the world. While this interview was conducted before the December 2020 surge, the concepts and decision-making process that guide him in advising his patients remain the same.

He explains the important concept of R₀or reproduction number_. This number helps him guide his patients.

R₀, pronounced “R naught,” indicates how contagious an infectious disease is. It tells you the average number of people who will contract an infectious disease from one person who has it. For example, if a disease has an R₀ of 5 (and that might be about the R₀for COVID-19), a person who has the disease will transmit it, on average, to 5 other people.

There are three possibilities for the potential transmission or decline of a disease, depending on its R₀ value:

If R₀ is less than 1, each existing infection causes less than one new infection. In this scenario, the disease will eventually die out.
If R₀equals 1, each existing infection causes one new infection. The disease will stay alive and stable, but there won’t be a pandemic.
If R₀is greater than 1, as is the case with COVID-19, each infected person infects more than 1 new person. The number infected with the disease grows, and there could be an outbreak or if wider spread, an epidemic or if global, a pandemic.

Besides R₀, Dr. Kay also considers the prevalence of the disease in the patient’s community and his patient’s co-morbidity or other illnesses.

The news with COVID-19 changes fast. Unlike when we did the interview, we do now have an effective vaccine, at least for the general population.

But Dr. Kay, like me and Dr. Fauci, sees COVID-19 as a long-term issue for CLL patients and paints a realistic picture of the world we live in; a world where not everyone gets vaccinated or responds to the vaccine or wears a mask.

I can’t say please enjoy my interview with Dr. Kay, but I can say, it is important that you give a listen. He does talk about a way through vaccine and herd immunity.