COVID-19: 8* Tricky Questions for an Infectious Disease Specialist

Hey everyone! Hope you are taking good care of yourself while settling into your new normal. I know it's not easy and the feelings and moods we are experiencing in this time can be overwhelming and blind-siding. I have struggled with this myself this past week. Please remember that you are not alone and that every feeling you are experiencing is completely valid <3 This is unlike anything most of us have ever experienced in our lifetime. It's new and scary and taps into our deepest fears around our mortality and our sense of safety. That's a big deal. Have grace with yourself during this time and always <3

We are experiencing this virus in real time which means that we are constantly being updated with information that may or may not be accurate and/or helpful. This can overwhelm our system and can cause spikes in anxiety or send us spiraling into fear-based rabbit holes. Not cool. Not fun. And, I don't know about you, but I would like to experience that as infrequently as possible. One of the best ways to remedy feelings of anxiety around COVID-19 is to get accurate information from a credible source. I have really been feeling the American Liver Foundation recently because I can count on them to provide 'just the facts, ma'am" information from experts in the medical field (or mental health or nutrition) who know what they are talking about. They also have access to the latest COVID-19 info at the source (within the medical/ research institutions), not after the latest findings have trickled down and through various media organizations which skew the information to benefit their own agendas. The ALF wants you to be safe and healthy, period. And so do I!

So, here's one of the more recent vids the ALF has put out. This one asks and answers some of the more blurry, detailed questions we have like, "how long does this stuff really stay on surfaces?" and "how terrified of heavy breathing runners should I be?" I will give you a synopsis or overview of the questions, asked and answered, for the sake of time. The information in the video is comprehensive and also lengthy. So, I leave it up to you whether you would like to watch the whole thing (about 40 minutes in length). Also, the ALF has a helpline which you are welcome to call: 1-800-465-4837, Monday- Friday 9am-7pm. Please use this resource if you have some specific questions, concerns, scenarios etc. Remember, keeping informed keeps the stress down which is essential for your continued physical and mental health. Our bodies don't operate well when we are stressed. Get the information your body needs <3

Alright, alright, alright! Here we go!

Q: HOW LONG CAN THIS VIRUS LIVE ON SURFACES?

A: Anywhere from hours to days. 1 hr on copper, 7 hrs on plastic. Good news- the virus is completely destroyed by soap. Be a little concerned about high touch areas (phones, doorknobs etc) but, don't worry too much about it. Wash hands before and after anything you do and clean heavily trafficked surfaces more frequently than you have in the past. Really, just up your hygiene game and be mindful of what your hands are touching or have touched since last wash. When in doubt, wash your hands.

Q: CAN THE VIRUS STAY SUSPENDED IN THE AIR AND CAN I CATCH IT THAT WAY?

A: Airborne transmission form person to person over long distances is unlikely. Droplets from coughing or sneezing go about 2 meters or 6 ft and drift toward the floor in that process. Breath is not the main concern. Droplets from coughing and sneezing appear to be the main cause of transmission.

Q: DOES ASYMPTOMATIC INFECTION (SHOWING NO SIGNS OF ILLNESS) OCCUR AND HOW MUCH OF ASYMPTOMATIC INFECTION CONTRIBUTING TO THE ONGOING EPIDEMIC?

A: Yes, asymptomatic infection does and can occur. Yes, asymptomatic or pre-symptomatic is driving the rate of transmission. For example, from the data provided in the video, 44% of the transmissions occurred before the symptoms came.

Q: HOW IS THIS DIFFERENT FROM SARS? FROM INFLUENZA?

A: SARS- Really affected Asian countries and killed many people. SARS or COVID-1 kind of burned itself out and disappeared. The incubation period for COVID-19 is sneakier and the infectiousness is higher than it was for SARS.

INFLUENZA- Case mortality rate for influenza is much, much lower than that of COVID-19. COVID-19 is ten fold more lethal than influenza. Yowza. Also, influenza has been around for a really long time so a lot of people have partial immunity. COVID-19 on the other hand is a completely novel (new) virus which means none of us have ever experienced this virus before and therefore have zero immunity to it. We have no medication or vaccines for COVID-19. So, when comparing the flu to COVID-19, COVID-19 is more infectious, more lethal and we have zero developed immunity which makes it much more dangerous.

Q: WHEN WILL THIS EVER END? ARE WE STUCK WITH THIS LIKE THE SEASONAL FLU?

A: We don't have a crystal ball... First wave should crest between April and May, then there will be a long, slow decline. Some viruses, like the flu go away in the summer but, because the infectiousness of COVID-19 is so high and we don't have any immunity, it's very possible that it won't just go away in the summer. We are likely to see a 2nd wave in the fall that could be very dangerous. This is what happened with the Spanish Flu of 1918- the second wave was actually much worse than the first. Good news, we are developing therapies to help and the ultimate help will be a vaccine down the road.

Q: WHAT IS ALL THE MADNESS ABOUT HYDROXYCHLOROQUINE?

A: Anti-Malarial drug. Very effective in the treatment of Lupus- an auto-immune disorder and saves the lives of many of these folks. All the fuss was kicked off by a study published in France that looks really promising upon first glance. However, as with everything, when you dig a little deeper, things aren't as perfect as they seemed. For instance, the trial was not randomized and people were excluded to make the results seem more favorable. The study is an interesting starting point but it is not comprehensive enough to be touted as the thing that will fix everything. Additionally, a surge in demand would mean that the people with Lupus who rely on this drug to function or live, would be in danger of not being able to access the drug. We need bigger trials and bigger data and more studies before we can plan to use this as a potential treatment. The buzz around this is an anxiety-based, knee jerk response in a time of crisis. We need to breathe:) and slow down:) and get more information before we move forward to avoid causing additional harm.

Q: WHAT IS THE BEST TEST FOR COVID-19 AND HOW DO I GET ONE?

A: Throat swab and nasal swab for outpatient cases. The ultra-fast, 15 minutes tests you may have heard about, only run one sample at a time so, it's slower, but effective in hospital settings. Anti-body test used for HepB or HepC may not be as reliable for COVID-19 because there are other coronaviruses out there like, common coronaviruses, that cause 30-40% of colds that may register. Testing needs to be COVID-19 specific which we don't have yet. So, if you have symptoms, call doctors and see if they have testing, you will probably get a cotton swab in nose, result in a couple days and told to stay home. If you don't have symptoms, you wont be tested because tests take equipment and labor to run so notably sick people must be prioritized first. Also, studies show asymptomatic cases can cause more false positives in testing.

Hope this information was helpful! I will be keeping up with the latest, credible information about COVID-19 to ease some stress as we try and navigate this new way of being <3

Take good care,

Sue

*The video states 8 questions but, there were some combo questions and bonus ones thrown in there to muddy that number a bit. Just roll with it;)