• Dr. Khetarpal

COVID-19 Update - Without The BULL - Aug. 24, 2020

August 24, 2020 COVID-19 WEEKLY UPDATE

Covid-19 continues to ravage the US, Brazil, Mexico and other parts of the World including

India. In the US, California, Texas, Florida continue to suffer but now in the past week cases in Texas have dropped below 50,000 per day over the past week. However, cases in Ohio and the Midwest may be increasing with some suggestion of resurgence in NY/NJ. There has also been some resurgence although mild in Southeast Asia. And as summer winds down and we move into the fall season, a second wave may occur, causing further disruption in the economy and personal lives.

This is challenging all around. Positivity rates seem to vary but about 13-15% appear positive. There are concerns that testing may not be accurate. The Ohio governor was tested positive with the Quidel Sofia antigen test but two tests with PCR done the same day turned out to be negative. So real world accuracy may be different from that claimed on the basis of initial limited testing prior to approval of the test by the FDA. Good news is coming from several fronts:

1. The studies on vaccines by Moderna Therapeutics, Astra Zeneca and Pfizer/BioNtech are

enrolling very well with more than a third being enrolled already. Other vaccine

companies such as Novavax, Canoslim, Inovio Pharmaceuticals, Johnson and Johnson

are moving rapidly as well. It is quite possible that we may have more than one vaccine

by the end of the year given that the FDA requires only 50% efficacy.

2. A new drug named aviptadil showed benefit in an initial group of 21 crritically ill Covid-

19 patients that were on the ventilator or receiving ECMO in the ICU at Methodist

hospital in Houston. 19/21 patients improved, many of which were taken off the

ventilators or ECMO machine. The drug is now undergoing phase 3 trials in Miami,

California and Texas. Not only is the intravenous form of the drug being tested in clinical

trials, inhaled aviptadil is also scheduled to begin clinical trials shortly.

3. More testing is becoming available and FDA has approved a saliva test from Yale that

should allow more rapid detection of antigien at people’s homes or in Nursing homes. It

is likely that a 30-minute saliva test done at the point of care (individual home or

restaurant or a business) may become the defacto standard of care in the near future

and allow economies to open fully. If this test can be made cheap, a daily test may

become the standard.

Umang Khetarpal, MD

Texas Sinus, Allergy, Snoring and Sleep institute


Dr. Umang Khetarpal finished his medical school at the young age of 22 and is trained in Otolaryngology-Head and Neck and Facial Plastic Surgery. He completed his internship and specialty residency training in Syracuse, New York. He also has extensive research experience and additional clinical experience through fellowships at Massachusetts Eye and Ear Infirmary and Brigham and Women’s Hospital, Harvard Medical School in Boston. He has co-authored book chapters and many publications in peer reviewed journals within the specialty. He has presented at major specialty society meetings and at academic institutions. Topics of his research included hearing loss and balance disorders, sinus problems and sleep apnea. His recent research efforts have been entirely focused on sinusitis, especially recurrent acute rhinosinusitis, allergies and in office balloon sinuplasty and in office sinus surgery. He has recently presented five papers at the International meeting of Rhinology in CHicago, June 2019. He discovered and was the first to describe a novel ear disease in families that resulted in balance and hearing problems. His most innovative research was in the cutting-edge field of genetics in Otolaryngology where he was involved in finding the genetic defects for several different diseases. In addition, he has taken time to observe the surgical techniques of some of the world’s most renowned surgeons in plastics surgery. He had been featured 3 times over the years in newspapers in the Rio Grande Valley for introducing latest treatments in thyroid cancer, sleep apnea and sinus surgery locally. His current interest is in molecular genetics of allergic rhinitis and chronic sinusitis with and without polyps and in finding better cures for these conditions. He now calls Houston his home and is starting his practice in the Woodlands.

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