HomeMy WebLinkAbout02162021_Rennebohm_COVID ANALYSIS 39 LetterIn recent public statements Dr. Locke has emphasized the importance of taking the COVID-19 pandemic
seriously. Lives are at stake. This pandemic has been one of the most profound and potentially
transformative events in human history. Accordingly, this pandemic must be understood accurately,
deeply, and scientifically.
A major cause of COVID deaths has been life-taking hyperimmune reactions (e.g., “cytokine storm”)
triggered by the virus. Such hyperimmune reactions are not unique to COVID-19; in the past they have
been a leading cause of death in patients with many other viruses, including seasonal flu viruses and
common coronaviruses.
As a pediatric rheumatologist, I have been “on the front lines” for more than 40 years trying to save
children from life-threatening “cytokine storm” reactions. Pediatric rheumatologists have developed
life-saving treatments, including specific anti-cytokine therapies, which can be applied to “cytokine
storm” reactions triggered by any virus. In peer-reviewed journals we have shared our experience and
encouraged physicians caring for adults to implement a “pediatric rheumatology approach” to
treatment of severe COVID illness. A critically important component of that approach is to use Ct
values of COVID PCR tests to estimate a patient’s viral load, so that life-saving immunosuppression
can be administered in a timely and precise fashion.
Since the beginning of this pandemic, COVID PCR results have been reported only as positive or
negative, with no mention of how strongly or weakly positive---i.e., no mention of Ct values. Ct values
provide an imperfect estimation of viral load, but an imperfect estimate is better than no estimation at
all.
Knowing the Ct value at which a COVID test is positive is absolutely essential, not only when assessing
an individual patient, but also when collecting data regarding new COVID cases, and when making
public health policy. Still, however, Ct values have not been taken seriously and are not even being
reported. (For details about Ct values see “notes from the social clinic.org” website and recent article in
PT Free Press.)
During this COVID pandemic it is essential that public policy be based on epidemiologic data of the
highest quality. High quality epidemiologic data, as well as excellent care of severe COVID illness,
depend on wise use of Ct values. The Commissioners are s urged to support Dr. Locke’s obligation to
educate the public and public officials about Ct values. That is a profoundly important way to take the
pandemic seriously.
Robert Rennebohm, MD
Port Townsend