COVID-19 Q&A with Dr. Crymes

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Dr. William Crymes (above), practicing neuroradiologist, wrote "On going viral" for our June edition. He also granted us a Q&A session, which we are making available exclusively online.

Mercury: The directions issued by Dr. Fauci regarding those who’ve had the vaccine have shifted since the start. What is your opinion: Are fully vaccinated individuals safe or not?

Dr. Crymes: The reason Dr. Fauci’s directions changed was because the information we had about the virus changed. Nothing was known about COVID-19 before November 2019, and by January 2020 scientists had sequenced its genome. Based on more than 10 years of research on RNA vaccines, we had an approved vaccine less than 11 months after the first American death. Fauci based every decision on available information that changed on the hour.

No vaccine is 100 percent effective, and thus fully vaccinated individuals are not 100 percent safe. However, with the current two-dose vaccines for COVID-19, a fully vaccinated individual is 95 percent safe. This in layman’s terms means that vaccinated individuals are 20 times less likely to become infected than those who are not vaccinated.

Mercury: It is our understanding that testing for antibodies is the best way to tell who is immune. Is this true? If so, will that sort of testing become faster and easier?

Dr. Crymes: This is a complex question that requires understanding the prevalence of a disease in a population. As of May 1, 2021, a little over 33 million Americans tested positive for the virus, which means 90 percent of Americans have not. When you have a relatively low prevalence of a disease (in the case of this virus, 10 percent), it affects the predictive value of tests. So if you have a COVID-19 antibody test that is negative (no antibodies for the virus), there is about a 95 percent chance that you haven’t had the virus. By contrast, if you test positive for COVID-19 antibodies there is only a 50 percent chance that you had the virus. This can be improved if you test for different types of antibodies (for the nerds like me, IgG vs. IgM), but even with the best antibody tests all people should get the vaccine — even those who have had the virus.

Mercury: Would individuals have a valid legal objection to being required to provide proof of vaccination for air travel or other access to public spaces under HIPAA?

Dr. Crymes: HIPAA controls the transfer of protected patient information between medical businesses and medical professionals. It does not address how a patient or individual handles their own medical information. For instance, I can disclose to everyone that I received my second dose of the Pfizer vaccine in January of this year because it’s my choice. As a physician, I cannot disclose to anyone if my patient received the vaccine without the express permission of my patient.

The issue with the so-called vaccination passports is that if enough people are not vaccinated to reach herd immunity, proof of vaccination may be needed to attend mass events, especially indoors. Think of it this way: The virus couldn’t care less about an individual’s right to not disclose their vaccination status. And if it could express emotions, COVID-19 would be thrilled if there were laws that expressly protected unvaccinated people from revealing their unvaccinated status.

There is no requirement for me to reveal if I am intoxicated before I drive a car. Daily deaths in America due to DUI average about 28, while COVID-19 deaths on average 1,300 per day since the first death in the U.S. So, it’s 46 times more likely you will die of COVID-19 than from DUI. If you are intoxicated and kill someone, it’s a felony. Currently, there are laws in Florida protecting your right to spread the virus. These are both preventable causes of death: one choice is made drunk, the other sober.

Mercury: Whether or not masks are effective has been hotly debated since COVID-19 surfaced. We’ve read that this virus spreads like the flu and also that flu cases virtually disappeared this year due to mask wearing and other precautions. However, COVID-19 still continued to spread, causing some to question the facts on how COVID is spread. Is this a related phenomenon or just a misunderstanding of the data?

Dr. Crymes: This has been a very misunderstood subject. Think about why doctors and nurses wear masks during surgery: They do this to protect the patient, to prevent infecting them with their germs — the same reason they wear gloves and gowns. These two-ply masks are five to ten times better at preventing you from spreading the virus than they are from contracting the virus. Most people would say they wear a mask and get the vaccine to prevent themselves from getting sick. This is true, but what that person is actually doing is preventing the spread of the virus, which is how you end a pandemic. The spread of COVID-19 and seasonal flu are similar, which is why influenza rates have plummeted. The reason that COVID-19 continues to spread is that it is more contagious than the flu.

Mercury: One of our team members continues to test negative despite repeated exposures to people who tested positive. Similarly, the vast range of symptoms and severity seems difficult to predict. What’s behind the idea that “either you’re susceptible to COVID or you’re not”?

Dr. Crymes: There could be several explanations for someone testing negative despite multiple positive contacts. Type O blood affords some native protection from the virus, but people who have type O can still get the virus. Another possibility is that your team member has had asymptomatic virus and is immune. One caveat — we know the current vaccines protect better and longer than an immune response from prior COVID-19 exposure.

Mercury: How much should we be worried about variants of COVID-19 that seem to affect younger people — for example, reports of children hospitalized with COVID in Michigan? What are the implications for vaccination?

Dr. Crymes: Everyone should be worried about COVID-19 variants regardless of what nasty tricks they possess. These viruses are really good at mutating, which is how you get the variants. The only way to prevent mutations in the virus is to stop the spread of the virus. The only way to stop the spread is to wear a mask when appropriate and get vaccinated. If we don’t stop the spread, it is almost guaranteed that there will be a variant that is resistant to the current vaccines.

Mercury: There is a huge conflict between wanting to do what’s effective for personal and public health and distrust of the medical industry or governmental health agencies that have broken our trust many times, even well before COVID-19 surfaced. How should citizens deal with this situation and how will we restore faith in our government health services and the pharmaceutical/private medical institutions?

Dr. Crymes: The only way to deal with this situation is to become informed citizens. The best way to become informed is to get your information from multiple sites. If you see on one news channel that the COVID-19 pandemic is over, go to a couple more news channels or websites and see if they are reporting the same. If you hear that the vaccines can affect your ability to have children, ask your doctor (they will tell you there is absolutely no evidence the vaccine causes infertility). If someone tells you the vaccine has microchips designed by Bill Gates to be able to track your movements, tell them there aren’t tracking microchips that can fit in a COVID-19 vaccine injection needle and ask them why would anyone need to track you when you carry a cell phone around all day.

Seriously, always confirm your information with at least two sources, and neither of those sources should be a social media platform. Most social media platforms are deplorable at controlling content, and false information can spread like wildfire; the Bill Gates tracking microchip story is an actual conspiracy theory. The CDC and John Hopkins’s websites are outstanding for information regarding all infectious diseases.

The only way to restore the lost faith is to become informed.

William B. Crymes, Jr. earned a bachelor’s from Emory University in 1992, a master’s in molecular genetics from University of South Carolina in 1998 and a doctorate in medicine in 2003 from Medical University of South Carolina. After graduating from medical training, he held an associate professorship in radiology at Emory School of Medicine before returning to Charleston, where he has been a practicing neuroradiologist for the last 11 years. He is eternally grateful for his wife of 24 years and two children for putting up with almost daily scientific rantings.