Raymond Pontzer, MD, FACP, the chief of infectious diseases at UPMC’s St. Margaret Hospital in Pittsburgh talks about what you can do to protect yourself against the coronavirus.
If one person does test positive in your house, is there a way for everybody else who lives in that household to protect themselves? How should they do that?
Pontzer: The other people in the house that are not ill and not suspected to have the disease should protect themselves from the person residing in the household who may be sick. And there is a good outline in the CDC website on how to do that. I would refer people that have access to go to www.cdc.gov. There’s a section that says what to do if you are sick and you can go through it, it will tell you measures to take. They would like to physically distance the person if possible, within the household. Minimize contact, separate dishes, separate toiletries, separate bathrooms if possible. Really try to minimize contact. Now obviously you’re in the same household, different houses are constructed differently, so you’re going to have to work on this on the fly. But I would refer they go to the CDC site for more details. Certainly, frequent hand washing is important also.
When you’re talking about separate rooms, especially separate dinnerware and separate toiletries and use a different bathroom, how long should that be for the two-week period or how long would they have to take those extra measures?
Pontzer: Right now, when patients are sequestered at home or quarantined in their home, the official recommendation is to not end the quarantine until you test negative. They’d like to negative tests, so that would be a good marker if that’s feasible. Getting the testing done and accessibility to testing is not always quite easy. So that may not be available in every case. I would say that ideally if can’t get tested like that, you would want to wait until the symptoms abate. You feel normal. The fever, cough and other symptoms have gone away. And then an additional three to five days.
Can someone get this virus, this particular COVID 19 virus more than one time? Can we get it two and three times?
Pontzer: We don’t know that. The virus is new, so we have no historical basis to look at. If you’re going to get it a second time, it probably would be significant period after the first time, but we don’t even know if that’s possible. So, the answer is we really don’t know.
Some of the long-term effects of COVID 19, what can people expect? For a couple of weeks after, a couple of months after, maybe even a year after you have this condition.
Pontzer: The spectrum of the illness is quite different from person to person. We know that a lot of younger people, particularly children, can have very mild disease. There may be a significant number of asymptomatic cases. We don’t really know that for a fact though because there hasn’t been enough testing. We do know though, that those people can recover and feel perfectly well with no long-term side effects. However, there have been some individuals, I mean there is a broad spectrum of severity, people can get very ill, they can have long-term morbidity. They can have what appears to be significant scarring in their lungs. They may have difficulties, with their respiratory system breathing forever after they have it. We don’t know that for a fact either because the disease is so new. But we do know that some people have had very long recovery periods have not returned to their baseline and they may have permanent damage. So, the spectrum is broad. We know that older individuals get more severe disease and they may have more long-term side effects thereafter for an uncertain period of time.
You had mentioned that one of the myths that we had heard a lot about from our stations was the threat to kids and people under 18. Is it true that there’s no real threat to kids under 18? And why are we seeing more cases in the middle-aged and older people?
Pontzer: Certainly, kissing can certainly transmit the disease. I don’t think there’s any question about that. So, my advice would be to refrain from kissing. Certainly, that can transmit the disease, particularly during this pandemic. But secondly, why don’t younger people seem to become as sick as older people? We don’t know the answer to that. We can theorize. We know the immune systems are different, they’re more robust in young people. We also know that older individuals have more comorbid conditions. We know there’s a definite association between having high blood pressure, chronic lung disease and heart disease. Those people get sicker on average. There are multiple factors that we can theorize why the older people become sicker than younger people. But to be certain, these are just theories at this point.
Will warm weather effect the virus? We had heard that sometimes temperatures in the mid-eighties might slow the spread of this virus. Is that myth or is that true?
Pontzer: We don’t have any facts yet with the current coronavirus. We do have experience with other coronaviruses that we’ve known about that have infected humans for a long time. We test for four different coronaviruses frequently when we’re looking for viral infections in our patients before the new COVID-19. We do know that those viruses tend to be seasonal, like the flu, so that during the winter months they are more prevalent, more people are infected with coronavirus, the old type coronavirus. Many of us are hopeful that as the warmer weather hits the Northern hemisphere, that we will see a downward trend. And whether it’s due to the weather or due to other factors, we won’t know. But certainly, we’re hoping that could be a contributing factor. But it’s a brand-new virus. We have no history with it, so there’s really no guarantees. We don’t know for sure if the warm weather is going to impact it or not.
Are there more dangers in different parts of the country? High altitudes, beach, warm weather, places like the South and Florida? Are there different areas where, where you’re at a higher risk?
Pontzer: Not that we know of. We don’t know of any, change in risk factor based upon geography. It’s infected people at low and high altitudes in China but I personally don’t know if there’s going to be any change. We’re pretty much making recommendations as CDC is, across the board no matter what part of the country you live in, it’s the same recommendations. They have concerns that this pandemic will wave through all parts of the country and I tend to believe that’s probably going to be true.
Could we see a resurgence of this in the fall?
Pontzer: Oh, absolutely. That’s possible. I believe when we look at other coronaviruses, we know that there is a resurgence of those viruses as the colder months come upon us. So, it is possible that this may dissipate somewhat in the summer months and come back again in the fall. That is very possible.
Do we necessarily have to give up our outdoor sports like golf or tennis or pickleball or running anything where we’re not in direct contact with, with people?
Pontzer: Yeah. I believe that as long as you’re out there as an individual or you’re fairly well distanced from whoever you’re having your sporting with, you’re probably okay. I believe that certainly hiking, running those individual sports, I see no reason why that would pose an increased risk. I would certainly not discourage that. Playing tennis, if you have a doubles partner and you’re banging into that doubles partner, that might be a risk. I’m not sure I’ve ever played pickleball, but it really depends on if the participants are in close proximity or not. It’s all about distancing. You want to try to stay six feet away from other people if at all possible when you’re out and about. And if you can do that, I don’t see any reason to discourage sports. Individual sports are good alternatives as opposed to going to the gym and whatnot. So yeah, I would encourage people to go out and exercise and if they can walk or run or hike, those seem to me to be ideal ways to do it
For parents with younger kids. Is it safe to let them play at the outdoor playgrounds, cause kids are going to feel cooped up a little bit. How long can this virus live on metal and plastic?
Pontzer: The virus we know can stay on for hours, up to day or so. I don’t know precisely the longest duration, but we do know with other viruses that they can stay on surfaces for prolonged periods of time. That doesn’t necessarily mean that those surfaces are going to be infectious for those periods of time because the amount of virus, even though we can detect it, drops significantly and you need a certain inoculum size to infect individuals. So, the fact that you might hear that the virus can live for a day or three days on a tabletop doesn’t mean that that tabletops is infectious. It’s probably most concerning within a few hours after it’s been touched by somebody who’s infected, particularly if it’s damp that can make it go viable for a longer period of time. But certainly, there’s a lot more virus on people’s skin than there is on inanimate objects. That’s a more of a concern is touching individuals as opposed to touching inanimate objects. But we are concerned about that and if there’s a lot of high touch areas, there could be significant virus there and certainly there is the potential to pick up the disease that way.
They had heard if you drink a lot of water, especially warm water, the virus lives in your throat and that brings the virus down to your stomach and you’ll be okay. Is that true?
Pontzer: I don’t think that’s true at all. There is no evidence to support that and I would say no.
If you’re going through an area with a crowd of people, hold your breath as long as you can and you’ll avoid getting infected.
Pontzer: That’s impossible to do. So, I would say that the intermittently holding your breath is extremely unlikely to prevent infection. Again, there is no evidence. I generally tell people that when they get on planes, they should hold their breath till they get off, but unfortunately that doesn’t work either.
We’ve heard a lot of people say at least early on, as far as for coronavirus it’s really no different than a bad flu. How do you feel about that?
Pontzer: I feel that’s a mistake. We know that coronavirus, particularly in the elderly, is much more severe than the circulating flu strains right now as we see now the infection and people that are greater than 70 years old, it has about an 8% mortality. People greater than 80 years old, about a 15% mortality that is significantly greater than the flu, particularly any elderly individuals. There is no question that this organism is much more severe than our typical flu.
Is there anything I didn’t ask you?
Pontzer: Yeah, I just want them to know that what the public health officials are doing now to close places to do social distancing really has some scientific backing. What we’re trying to do, we’re not going to contain this or end this disease, but we want to slow the disease. And it’s important because if we can slow the disease, then our healthcare capacity can be maintained. We’ll be able to take care of those who do get sick. It will give us more time to develop vaccines and medications that might be utilized to help this down the road for people that we can delay it. It is important to try to maintain this for a period of time. We know that in other areas of the world, this has helped. So, I just want to encourage people to pause and go with the current recommendations.
END OF INTERVIEW
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